Surgical instrument articulation joint arrangements comprising multiple moving linkage features

ABSTRACT

Articulation joint arrangements for facilitating multi-axis articulation of a surgical end effector relative to a shaft assembly of a surgical instrument.

BACKGROUND

The present invention relates to surgical instruments and, in variousarrangements, to surgical stapling and cutting instruments, endeffectors, and staple cartridges for use therewith that are designed tostaple and cut tissue.

BRIEF DESCRIPTION OF THE DRAWINGS

Various features of the embodiments described herein, together withadvantages thereof, may be understood in accordance with the followingdescription taken in conjunction with the accompanying drawings asfollows:

FIG. 1 is a perspective view of a surgical stapling instrumentcomprising a handle, a shaft assembly, and an end effector, inaccordance with at least one aspect of the present disclosure.

FIG. 2 is a perspective view of the end effector and a portion of theshaft assembly of the surgical stapling instrument of FIG. 1, whereinthe end effector is illustrated in a straight, or non-articulated,configuration, in accordance with at least one aspect of the presentdisclosure.

FIG. 3 is a perspective view of the end effector and a portion of theshaft assembly of the surgical stapling instrument of FIG. 1, whereinthe end effector is illustrated in an articulated configuration, inaccordance with at least one aspect of the present disclosure.

FIG. 4 is an exploded perspective view of the end effector and a portionof the shaft assembly of the surgical stapling instrument of FIG. 1, inaccordance with at least one aspect of the present disclosure.

FIG. 5 is a cross-sectional elevation view of the end effector and aportion of the shaft assembly of the surgical stapling instrument ofFIG. 1, wherein the end effector is illustrated in an unfired, clampedconfiguration, in accordance with at least one aspect of the presentdisclosure.

FIG. 6 is a plan view of the end effector and a portion of the shaftassembly of the surgical stapling instrument of FIG. 1, in accordancewith at least one aspect of the present disclosure.

FIG. 7 is a cross-sectional elevation view of the end effector and aportion of the shaft assembly of FIG. 1 taken along section line 6-6 inFIG. 6, wherein the end effector is illustrated in an openconfiguration, in accordance with at least one aspect of the presentdisclosure.

FIG. 8 is a cross-sectional elevation view of the end effector and aportion of the shaft assembly of FIG. 1 taken along section line 7-7 inFIG. 6, wherein the end effector is illustrated in a clampedconfiguration, in accordance with at least one aspect of the presentdisclosure.

FIG. 9 is a perspective view of a surgical stapling assembly comprisinga shaft assembly and the end effector of FIG. 1, wherein the endeffector is attached to the shaft assembly by way of an articulationjoint, in accordance with at least one aspect of the present disclosure.

FIG. 10 is an exploded perspective view of the surgical staplingassembly of FIG. 9, in accordance with at least one aspect of thepresent disclosure.

FIG. 11 is a cross-sectional elevation view of the surgical staplingassembly of FIG. 9, wherein the end effector is illustrated in anunfired, clamped configuration, in accordance with at least one aspectof the present disclosure.

FIG. 12 is a perspective view of a surgical stapling assembly comprisinga shaft assembly and the end effector of FIG. 1, wherein the endeffector is attached to the shaft assembly by way of an articulationjoint, in accordance with at least one aspect of the present disclosure.

FIG. 13 is an exploded perspective view of the surgical staplingassembly of FIG. 12, in accordance with at least one aspect of thepresent disclosure.

FIG. 14 is a cross-sectional elevation view of the surgical staplingassembly of FIG. 12, wherein the end effector is illustrated in anunfired, clamped configuration, in accordance with at least one aspectof the present disclosure.

FIG. 15 is a perspective view of a surgical stapling assembly comprisinga shaft assembly and the end effector of FIG. 1, wherein the endeffector is attached to the shaft assembly by way of an articulationjoint, in accordance with at least one aspect of the present disclosure.

FIG. 16 is an exploded perspective view of the surgical staplingassembly of FIG. 15, in accordance with at least one aspect of thepresent disclosure.

FIG. 17 is a cross-sectional elevation view of the surgical staplingassembly of FIG. 15, wherein the end effector is illustrated in anunfired, clamped configuration, in accordance with at least one aspectof the present disclosure.

FIG. 18 is a perspective view of a surgical end effector assemblycomprising the end effector of FIG. 1 and a flexible firing drivesystem, in accordance with at least one aspect of the presentdisclosure.

FIG. 19 is an exploded perspective view of the surgical staplingassembly of FIG. 18, in accordance with at least one aspect of thepresent disclosure.

FIG. 20 is a cross-sectional elevation view of the surgical end effectorassembly of FIG. 18, wherein the surgical end effector assembly isillustrated in an unfired, clamped configuration, in accordance with atleast one aspect of the present disclosure.

FIG. 21 is a perspective view of robotic controller, in accordance withat least one aspect of the present disclosure.

FIG. 22 is a perspective view of a robotic arm cart for a roboticsurgical system, depicting manipulators on the robotic arm cart operablysupporting surgical tools, in accordance with at least one aspect of thepresent disclosure.

FIG. 23 is a side view of a manipulator of the surgical arm cart of FIG.22 and a surgical grasping tool, in accordance with at least one aspectof the present disclosure.

FIG. 24 is a diagrammatical depiction of an example of an additivemanufacturing system, in accordance with at least one aspect of thepresent disclosure.

FIG. 25 is a chart depicting one form of a manufacturing process thatmay be implemented by the additive manufacturing system of FIG. 24, inaccordance with at least one aspect of the present disclosure.

FIG. 26 is a perspective view of one form of a universally movable jointthat may be formed using the manufacturing process of FIG. 25 and theadditive manufacturing system of FIG. 24, in accordance with at leastone aspect of the present disclosure.

FIG. 27 is a cross-sectional view of the universally movable joint ofFIG. 26, in accordance with at least one aspect of the presentdisclosure.

FIG. 28 is another perspective view of the universally movable joint ofFIG. 26, in accordance with at least one aspect of the presentdisclosure.

FIG. 29 is a cross-sectional perspective view of the universally movablejoint of FIG. 26, in accordance with at least one aspect of the presentdisclosure.

FIG. 30 is another cross-sectional view of the universally movable jointof FIG. 26 supported on a build plate of the additive manufacturingsystem of FIG. 24, in accordance with at least one aspect of the presentdisclosure.

FIG. 30A is another cross-sectional perspective view of the universallymovable joint of FIG. 26 in green form, in accordance with at least oneaspect of the present disclosure.

FIG. 30B is an enlarged view of a portion of a second cap and a bottomjoint ring and a fillet space therebetween filled with an amount ofbuild material in a first state during the formation of the greenuniversally movable joint of FIG. 30, in accordance with at least oneaspect of the present disclosure.

FIG. 30C is an enlarged view of a portion of a second cap and a portionof a joint spine of the green universally movable joint of FIG. 30illustrating amounts of a build material in a first state located in asecond horizontal joint space between the second cap and the jointspine, in accordance with at least one aspect of the present disclosure.

FIG. 31 is a cross-sectional view of another universally movable jointin green form supported on a build plate of the additive manufacturingsystem of FIG. 24 by multiple support members, in accordance with atleast one aspect of the present disclosure.

FIG. 32 is a cross-sectional view of another universally movable jointin green formed supported on a build plate of the additive manufacturingsystem of FIG. 24, wherein a build material and a separate supportmaterial are employed during the manufacturing process, in accordancewith at least one aspect of the present disclosure.

FIG. 33 is a cross-sectional view of another universally movable jointin green formed supported on a build plate of the additive manufacturingsystem of FIG. 24, wherein a joint spine is formed from a first buildmaterial and a vertical U-joint member and a horizontal U-joint memberare formed from a second build material and a separate support materialis employed during the manufacturing process, in accordance with atleast one aspect of the present disclosure.

FIG. 34 is a perspective view of another universally movable jointembodiment, in accordance with at least one aspect of the presentdisclosure.

FIG. 35 is a cross-sectional view of the universally movable joint ofFIG. 34, in accordance with at least one aspect of the presentdisclosure.

FIG. 36 is another cross-sectional view of the universally movable jointof FIG. 34, in accordance with at least one aspect of the presentdisclosure.

FIG. 37 is a perspective view of a universally movable drive shaftsegment that comprises multiple universally movable joints that may beformed using the additive manufacturing system of FIG. 24 and/or themanufacturing process of FIG. 25, in accordance with at least one aspectof the present disclosure.

FIG. 38 is an exploded perspective assembly view of an articulationjoint assembly embodiment that may be formed using the additivemanufacturing system of FIG. 24 and/or the manufacturing process of FIG.25, in accordance with at least one aspect of the present disclosure.

FIG. 39 is a perspective view of the articulation joint assembly of FIG.38 showing a portion of a shaft assembly and a portion of an endeffector in phantom lines, in accordance with at least one aspect of thepresent disclosure.

FIG. 40 is another perspective view of the articulation joint assemblyof FIG. 38, in accordance with at least one aspect of the presentdisclosure.

FIG. 41 is a perspective assembly view of another articulation jointassembly embodiment that may be formed using the additive manufacturingsystem of FIG. 24 and/or the manufacturing process of FIG. 25, inaccordance with at least one aspect of the present disclosure.

FIG. 42 is a perspective view of a mounting member embodiment and auniversally movable joint embodiment, in accordance with at least oneaspect of the present disclosure.

FIG. 43 is another perspective view of the mounting member anduniversally movable joint of FIG. 42 with a portion of a shaft, aconduit or a shaft guide extending through a center passage in themounting member, in accordance with at least one aspect of the presentdisclosure.

FIG. 44 is a perspective view of a portion of an articulation jointembodiment coupling an end effector to a shaft assembly, in accordancewith at least one aspect of the present disclosure.

FIG. 45 is a cross-sectional view of an intermediate closure drive shaftportion of the articulation joint of FIG. 44, in accordance with atleast one aspect of the present disclosure.

FIG. 46 is a cross-sectional view of an intermediate firing drive shaftportion of the articulation joint of FIG. 44, in accordance with atleast one aspect of the present disclosure.

FIG. 47 is a cross-sectional view of a portion of the end effector ofFIG. 44 showing a coupling between a distal closure drive shaft and aclosure screw and a coupling between a distal firing drive shaft and afiring screw, in accordance with at least one aspect of the presentdisclosure.

FIG. 48 is a cross-sectional end view of a closure coupler of FIG. 47taken along section line 48-48 in FIG. 47, in accordance with at leastone aspect of the present disclosure.

FIG. 49 is a cross-sectional view of a portion of another end effectorshowing a coupling between a distal closure drive shaft and a closurescrew and a coupling between a distal firing drive shaft and a firingscrew, in accordance with at least one aspect of the present disclosure.

FIG. 50 is a cross-sectional view of an articulation region of anothersurgical instrument, in accordance with at least one aspect of thepresent disclosure.

FIG. 51 is a perspective view of a portion of another surgicalinstrument, in accordance with at least one aspect of the presentdisclosure.

FIG. 52 is an exploded assembly view of a portion of the surgicalinstrument of FIG. 51, in accordance with at least one aspect of thepresent disclosure.

FIG. 53 is a cross-sectional view of a portion of the surgicalinstrument of FIG. 51, in accordance with at least one aspect of thepresent disclosure.

FIG. 54 is a perspective view of a shaft guide embodiment, in accordancewith at least one aspect of the present disclosure.

FIG. 55 is a proximal end view of the shaft guide embodiment of FIG. 54,in accordance with at least one aspect of the present disclosure.

FIG. 56 is a distal end view of the shaft guide embodiment of FIG. 54,in accordance with at least one aspect of the present disclosure.

FIG. 57 is a side view of the shaft guide embodiment of FIG. 54, inaccordance with at least one aspect of the present disclosure.

FIG. 58 is another side view of the shaft guide embodiment of FIG. 54,in accordance with at least one aspect of the present disclosure.

FIG. 59 is another view of the shaft guide embodiment of FIG. 54 in aflexed position, in accordance with at least one aspect of the presentdisclosure.

FIG. 60 is another view of the shaft guide embodiment of FIG. 54 inanother flexed position, in accordance with at least one aspect of thepresent disclosure.

FIG. 61 is another view of the shaft guide embodiment of FIG. 54, inaccordance with at least one aspect of the present disclosure.

FIG. 62 is a cross-sectional view of the shaft guide embodiment of FIG.56 taken along section line 62-62 in FIG. 56, in accordance with atleast one aspect of the present disclosure.

FIG. 63 is a perspective view of a portion of another surgicalinstrument, in accordance with at least one aspect of the presentdisclosure.

FIG. 64 is an exploded assembly view of a portion of the surgicalinstrument of FIG. 63, in accordance with at least one aspect of thepresent disclosure.

FIG. 65 is a side view of an articulation joint assembly of the surgicalinstrument of FIG. 63, in accordance with at least one aspect of thepresent disclosure.

FIG. 66 is another side view of the articulation joint assembly of thesurgical instrument of FIG. 63, in accordance with at least one aspectof the present disclosure.

FIG. 67 is another view of the articulation joint assembly of thesurgical instrument of FIG. 63 in articulated configuration, inaccordance with at least one aspect of the present disclosure.

FIG. 68 is another view of the articulation joint assembly of thesurgical instrument of FIG. 63 in another articulated configuration, inaccordance with at least one aspect of the present disclosure.

FIG. 69 is a perspective view of the articulation joint assembly of FIG.68 with two articulation link members removed for clarity, in accordancewith at least one aspect of the present disclosure.

FIG. 70 is an end view of a portion of the articulation joint assemblyof FIG. 69, in accordance with at least one aspect of the presentdisclosure.

FIG. 71 is a perspective view of a shaft guide of the articulation jointassembly of the surgical instrument of FIG. 63, in accordance with atleast one aspect of the present disclosure.

FIG. 72 is a perspective view of the articulation joint assembly of thesurgical instrument of FIG. 63, in accordance with at least one aspectof the present disclosure.

FIG. 73 is a cross-sectional view of the articulation joint assembly ofthe surgical instrument of FIG. 63, in accordance with at least oneaspect of the present disclosure.

FIG. 74 is a partial perspective view of an articulation system, inaccordance with at least one aspect of the present disclosure.

FIG. 75 is a top view of a portion of another end effector in anunarticulated position, in accordance with at least one aspect of thepresent disclosure.

FIG. 76 is another top view of the end effector of FIG. 75 in a fullyarticulated position, in accordance with at least one aspect of thepresent disclosure.

Corresponding reference characters indicate corresponding partsthroughout the several views. The exemplifications set out hereinillustrate various embodiments of the invention, in one form, and suchexemplifications are not to be construed as limiting the scope of theinvention in any manner.

DETAILED DESCRIPTION

Applicant of the present application owns the following U.S. PatentApplications that were filed on even date herewith and which are eachherein incorporated by reference in their respective entireties:

-   -   U.S. Patent Application entitled METHOD OF USING A POWERED        STAPLING DEVICE, Attorney Docket No. END9298USNP1/200859-1M;    -   U.S. Patent Application entitled SURGICAL STAPLING ASSEMBLY        COMPRISING NONPLANAR STAPLES AND PLANAR STAPLES, Attorney Docket        No. END9298USNP2/200859-2;    -   U.S. Patent Application entitled SURGICAL STAPLE CARTRIDGE        COMPRISING LONGITUDINAL SUPPORT BEAM, Attorney Docket No.        END9298USNP3/200859-3;    -   U.S. Patent Application entitled ROTARY-DRIVEN SURGICAL STAPLING        ASSEMBLY COMPRISING ECCENTRICALLY DRIVEN FIRING MEMBER, Attorney        Docket No. END9298USNP4/200859-4;    -   U.S. Patent Application entitled ROTARY-DRIVEN SURGICAL STAPLING        ASSEMBLY COMPRISING A FLOATABLE COMPONENT, Attorney Docket No.        END9298USNP5/200859-5;    -   U.S. Patent Application entitled DRIVERS FOR FASTENER CARTRIDGE        ASSEMBLIES HAVING ROTARY DRIVE SCREWS, Attorney Docket No.        END9298USNP6/200859-6;    -   U.S. Patent Application entitled MATING FEATURES BETWEEN DRIVERS        AND UNDERSIDE OF A CARTRIDGE DECK, attorney Docket No.        END9298USNP7/200859-7;    -   U.S. Patent Application entitled LEVERAGING SURFACES FOR        CARTRIDGE INSTALLATION, Attorney Docket No.        END9298USNP8/200859-8;    -   U.S. Patent Application entitled FASTENER CARTRIDGE WITH        NON-REPEATING FASTENER ROWS, Attorney Docket No.        END9298USNP9/200859-9;    -   U.S. Patent Application entitled FIRING MEMBERS HAVING FLEXIBLE        PORTIONS FOR ADAPTING TO A LOAD DURING A SURGICAL FIRING STROKE,        Attorney Docket No. END9298USNP10/200859-10;    -   U.S. Patent Application entitled STAPLING ASSEMBLY COMPONENTS        HAVING METAL SUBSTRATES AND PLASTIC BODIES, Attorney Docket No.        END9298USNP11/200859-11;    -   U.S. Patent Application entitled MULTI-AXIS PIVOT JOINTS FOR        SURGICAL INSTRUMENTS AND METHODS OF MANUFACTURING SAME, Attorney        Docket No. END9298USNP12/200859-12; and    -   U.S. Patent Application entitled JOINT ARRANGEMENTS FOR        MULTI-PLANAR ALIGNMENT AND SUPPORT OF OPERATIONAL DRIVE SHAFTS        IN ARTICULATABLE SURGICAL INSTRUMENTS, Attorney Docket No.        END9298USNP13/200859-13.

Applicant of the present application owns the following U.S. PatentApplications and U.S. Patents that were filed on Dec. 19, 2017 and whichare each herein incorporated by reference in their respectiveentireties:

-   -   U.S. Pat. No. 10,835,330, entitled METHOD FOR DETERMINING THE        POSITION OF A ROTATABLE JAW OF A SURGICAL INSTRUMENT ATTACHMENT        ASSEMBLY;    -   U.S. Pat. No. 10,716,565, entitled SURGICAL INSTRUMENTS WITH        DUAL ARTICULATION DRIVERS;    -   U.S. patent application Ser. No. 15/847,325, entitled SURGICAL        TOOLS CONFIGURED FOR INTERCHANGEABLE USE WITH DIFFERENT        CONTROLLER INTERFACES, now U.S. Patent Application Publication        No. 2019/0183491;10    -   U.S. Pat. No. 10,729,509, entitled SURGICAL INSTRUMENT        COMPRISING CLOSURE AND FIRING LOCKING MECHANISM;    -   U.S. patent application Ser. No. 15/847,315, entitled ROBOTIC        ATTACHMENT COMPRISING EXTERIOR DRIVE ACTUATOR, now U.S. Patent        Application Publication No. 2019/0183594; and    -   U.S. Design Patent No. D910,847, entitled SURGICAL INSTRUMENT        ASSEMBLY. Applicant of the present application owns the        following U.S. Patent Applications and U.S. Patents that were        filed on Jun. 28, 2017 and which are each herein incorporated by        reference in their respective entireties:    -   U.S. patent application Ser. No. 15/635,693, entitled SURGICAL        INSTRUMENT COMPRISING AN OFFSET ARTICULATION JOINT, now U.S.        Patent Application Publication No. 2019/0000466;    -   U.S. Patent application Ser. No. 15/635,729, entitled SURGICAL        INSTRUMENT COMPRISING AN ARTICULATION SYSTEM RATIO, now U.S.        Patent Application Publication No. 2019/0000467;    -   U.S. Patent Application Ser. No. 15/635,785, entitled SURGICAL        INSTRUMENT COMPRISING AN ARTICULATION SYSTEM RATIO, now U.S.        Patent Application Publication No. 2019/0000469;    -   U.S. patent application Ser. No. 15/635,808, entitled SURGICAL        INSTRUMENT COMPRISING FIRING MEMBER SUPPORTS, now U.S. Patent        Application Publication No. 2019/0000471;    -   U.S. patent application Ser. No. 15/635,837, entitled SURGICAL        INSTRUMENT COMPRISING AN ARTICULATION SYSTEM LOCKABLE TO A        FRAME, now U.S. Patent Application Publication No. 2019/0000472;    -   U.S. Pat. No. 10,779,824, entitled SURGICAL INSTRUMENT        COMPRISING AN ARTICULATION SYSTEM LOCKABLE BY A CLOSURE SYSTEM;    -   U.S. patent application Ser. No. 15/636,029, entitled SURGICAL        INSTRUMENT COMPRISING A SHAFT INCLUDING A HOUSING ARRANGEMENT,        now U.S. Patent Application Publication No. 2019/0000477;    -   U.S. patent application Ser. No. 15/635,958, entitled SURGICAL        INSTRUMENT COMPRISING SELECTIVELY ACTUATABLE ROTATABLE COUPLERS,        now U.S. Patent Application Publication No. 2019/0000474;    -   U.S. patent application Ser. No. 15/635,981, entitled SURGICAL        STAPLING INSTRUMENTS COMPRISING SHORTENED STAPLE CARTRIDGE        NOSES, now U.S. Patent Application Publication No. 2019/0000475;    -   U.S. patent application Ser. No. 15/636,009, entitled SURGICAL        INSTRUMENT COMPRISING A SHAFT INCLUDING A CLOSURE TUBE PROFILE,        now U.S. Patent Application Publication No. 2019/0000476;    -   U.S. Pat. No. 10,765,427, entitled METHOD FOR ARTICULATING A        SURGICAL INSTRUMENT;    -   U.S. patent application Ser. No. 15/635,530, entitled SURGICAL        INSTRUMENTS WITH ARTICULATABLE END EFFECTOR WITH AXIALLY        SHORTENED ARTICULATION JOINT CONFIGURATIONS, now U.S. Patent        Application Publication No. 2019/0000457;    -   U.S. Pat. No. 10,588,633, entitled SURGICAL INSTRUMENTS WITH        OPEN AND CLOSABLE JAWS AND AXIALLY MOVABLE FIRING MEMBER THAT IS        INITIALLY PARKED IN CLOSE PROXIMITY TO THE JAWS PRIOR TO FIRING;    -   U.S. patent application Ser. No. 15/635,559, entitled SURGICAL        INSTRUMENTS WITH JAWS CONSTRAINED TO PIVOT ABOUT AN AXIS UPON        CONTACT WITH A CLOSURE MEMBER THAT IS PARKED IN CLOSE PROXIMITY        TO THE PIVOT AXIS, now U.S. Patent Application Publication No.        2019/0000459;    -   U.S. Pat. No. 10,786,253, entitled SURGICAL END EFFECTORS WITH        IMPROVED JAW APERTURE ARRANGEMENTS;    -   U.S. patent application Ser. No. 15/635,594, entitled SURGICAL        CUTTING AND FASTENING DEVICES WITH PIVOTABLE ANVIL WITH A TISSUE        LOCATING ARRANGEMENT IN CLOSE PROXIMITY TO AN ANVIL PIVOT AXIS,        now U.S. Patent Application Publication No. 2019/0000461;    -   U.S. patent application Ser. No. 15/635,612, entitled JAW        RETAINER ARRANGEMENT FOR RETAINING A PIVOTABLE SURGICAL        INSTRUMENT JAW IN PIVOTABLE RETAINING ENGAGEMENT WITH A SECOND        SURGICAL INSTRUMENT JAW, now U.S. Patent Application Publication        No. 2019/0000462;    -   U.S. Pat. No. 10,758,232, entitled SURGICAL INSTRUMENT WITH        POSITIVE JAW OPENING FEATURES;    -   U.S. Pat. No. 10,639,037, entitled SURGICAL INSTRUMENT WITH        AXIALLY MOVABLE CLOSURE MEMBER;    -   U.S. Pat. No. 10,695,057, entitled SURGICAL INSTRUMENT LOCKOUT        ARRANGEMENT;    -   U.S. Design Patent No. D851,762, entitled ANVIL;    -   U.S. Design Patent No. D854,151, entitled SURGICAL INSTRUMENT        SHAFT; and    -   U.S. Design Patent No. D869,655, entitled SURGICAL FASTENER        CARTRIDGE.

Applicant of the present application owns the following U.S. PatentApplications and U.S. Patents that were filed on Jun. 27, 2017 and whichare each herein incorporated by reference in their respectiveentireties:

-   -   U.S. patent application Ser. No. 15/634,024, entitled SURGICAL        ANVIL MANUFACTURING METHODS, now U.S. Patent Application        Publication No. 2018/0368839;    -   U.S. Pat. No. 10,772,629, entitled SURGICAL ANVIL ARRANGEMENTS;    -   U.S. patent application Ser. No. 15/634,046, entitled SURGICAL        ANVIL ARRANGEMENTS, now U.S. Patent Application Publication No.        2018/0368841;    -   U.S. Pat. No. 10,856,869, entitled SURGICAL ANVIL ARRANGEMENTS;    -   U.S. patent application Ser. No. 15/634,068, entitled SURGICAL        FIRING MEMBER ARRANGEMENTS, now U.S. Patent Application        Publication No. 2018/0368843;    -   U.S. patent application Ser. No. 15/634,076, entitled STAPLE        FORMING POCKET ARRANGEMENTS, now U.S. Patent Application        Publication No. 2018/0368844;    -   U.S. patent application Ser. No. 15/634,090, entitled STAPLE        FORMING POCKET ARRANGEMENTS, now U.S. Patent Application        Publication No. 2018/0368845;    -   U.S. patent application Ser. No. 15/634,099, entitled SURGICAL        END EFFECTORS AND ANVILS, now U.S. Patent Application        Publication No. 2018/0368846; and    -   U.S. Pat. No. 10,631,859, entitled ARTICULATION SYSTEMS FOR        SURGICAL INSTRUMENTS.

Applicant of the present application owns the following U.S. PatentApplications that were filed on Jun. 2, 2020 and which are each hereinincorporated by reference in their respective entireties:

-   -   U.S. Design Patent Application Serial No. 29/736,648, entitled        STAPLE CARTRIDGE;    -   U.S. Design Patent Application Serial No. 29/736,649, entitled        STAPLE CARTRIDGE;    -   U.S. Design Patent Application Serial No. 29/736,651, entitled        STAPLE CARTRIDGE;    -   U.S. Design Patent Application Serial No. 29/736,652, entitled        STAPLE CARTRIDGE;    -   U.S. Design Patent Application Serial No. 29/736,653, entitled        STAPLE CARTRIDGE;    -   U.S. Design Patent Application Serial No. 29/736,654, entitled        STAPLE CARTRIDGE; and    -   U.S. Design Patent Application Serial No. 29/736,655, entitled        STAPLE CARTRIDGE.

Applicant of the present application owns the following U.S. DesignPatent Applications and U.S. Patents that were filed on Nov. 14, 2016,and which are each herein incorporated by reference in their respectiveentireties:

-   -   U.S. patent application Ser. No. 15/350,621, now U.S. Patent        Application Publication No. 2018/0132849, entitled STAPLE        FORMING POCKET CONFIGURATIONS FOR CIRCULAR STAPLER ANVIL;    -   U.S. patent application Ser. No. 15/350,624, now U.S. Patent        Application Publication No. 2018/0132854, entitled CIRCULAR        SURGICAL STAPLER WITH ANGULARLY ASYMMETRIC DECK FEATURES;    -   U.S. Design Patent No. D833,608, titled STAPLING HEAD FEATURE        FOR SURGICAL STAPLER; and    -   U.S. Design Patent No. D830,550, titled SURGICAL STAPLER.

Numerous specific details are set forth to provide a thoroughunderstanding of the overall structure, function, manufacture, and useof the embodiments as described in the specification and illustrated inthe accompanying drawings. Well-known operations, components, andelements have not been described in detail so as not to obscure theembodiments described in the specification. The reader will understandthat the embodiments described and illustrated herein are non-limitingexamples, and thus it can be appreciated that the specific structuraland functional details disclosed herein may be representative andillustrative. Variations and changes thereto may be made withoutdeparting from the scope of the claims.

The terms “comprise” (and any form of comprise, such as “comprises” and“comprising”), “have” (and any form of have, such as “has” and“having”), “include” (and any form of include, such as “includes” and“including”) and “contain” (and any form of contain, such as “contains”and “containing”) are open-ended linking verbs. As a result, a surgicalsystem, device, or apparatus that “comprises,” “has,” “includes” or“contains” one or more elements possesses those one or more elements,but is not limited to possessing only those one or more elements.Likewise, an element of a system, device, or apparatus that “comprises,”“has,” “includes” or “contains” one or more features possesses those oneor more features, but is not limited to possessing only those one ormore features.

The terms “proximal” and “distal” are used herein with reference to aclinician manipulating the handle portion of the surgical device. Theterm “proximal” refers to the portion closest to the clinician and theterm “distal” refers to the portion located away from the clinician. Itwill be further appreciated that, for convenience and clarity, spatialterms such as “vertical”, “horizontal”, “up”, and “down” may be usedherein with respect to the drawings. However, surgical device are usedin many orientations and positions, and these terms are not intended tobe limiting and/or absolute. In the following description, terms such as“first,” “second,” “top,” “bottom,” “up,” “down,” and the like are wordsof convenience and are not to be construed as limiting terms.

References to items in the singular should be understood to includeitems in the plural, and vice versa, unless explicitly stated otherwiseor clear from the text. Grammatical conjunctions are intended to expressany and all disjunctive and conjunctive combinations of conjoinedclauses, sentences, words, and the like, unless otherwise stated orclear from the context. Thus, the term “or” should generally beunderstood to mean “and/or”, etc.

Recitation of ranges of values herein are not intended to be limiting,referring instead individually to any and all values falling within therange, unless otherwise indicated herein, and each separate value withinsuch a range is incorporated into the disclosure as if it wereindividually recited herein. The words “about,” “approximately” or thelike, when accompanying a numerical value, are to be construed asindicating a deviation as would be appreciated by one of ordinary skillin the art to operate satisfactorily for an intended purpose. Similarly,words of approximation such as “approximately” or “substantially” whenused in reference to physical characteristics, should be construed tocontemplate a range of deviations that would be appreciated by one ofordinary skill in the art to operate satisfactorily for a correspondinguse, function, purpose or the like.

The use of any and all examples, or exemplary language (“e.g.,” “suchas,” or the like) provided herein, is intended merely to betterilluminate the embodiments and does not pose a limitation on the scopeof the embodiments. No language in the specification should be construedas indicating any unclaimed element as essential to the practice of theembodiments.

Various exemplary devices and methods are provided for performinglaparoscopic and minimally invasive surgical procedures. However, thereader will readily appreciate that the various methods and devicesdisclosed herein can be used in numerous surgical procedures andapplications including, for example, in connection with open surgicalprocedures. As the present Detailed Description proceeds, the readerwill further appreciate that the various surgical devices disclosedherein can be inserted into a body in any way, such as through a naturalorifice, through an incision or puncture hole formed in tissue, etc. Theworking portions or end effector portions of the surgical devices can beinserted directly into a patient's body or can be inserted through anaccess device that has a working channel through which the end effectorand elongate shaft of a surgical device can be advanced.

A surgical stapling system can comprise a shaft and an end effectorextending from the shaft. The end effector comprises a first jaw and asecond jaw. The first jaw comprises a staple cartridge. The staplecartridge is insertable into and removable from the first jaw; however,other embodiments are envisioned in which a staple cartridge is notremovable from, or at least readily replaceable from, the first jaw. Thesecond jaw comprises an anvil configured to deform staples ejected fromthe staple cartridge. The second jaw is pivotable relative to the firstjaw about a closure axis; however, other embodiments are envisioned inwhich the first jaw is pivotable relative to the second jaw. Thesurgical stapling system further comprises an articulation jointconfigured to permit the end effector to be rotated, or articulated,relative to the shaft. The end effector is rotatable about anarticulation axis extending through the articulation joint. Otherembodiments are envisioned which do not include an articulation joint.

The staple cartridge comprises a cartridge body. The cartridge bodyincludes a proximal end, a distal end, and a deck extending between theproximal end and the distal end. In use, the staple cartridge ispositioned on a first side of the tissue to be stapled and the anvil ispositioned on a second side of the tissue to be stapled. The anvil ismoved toward the staple cartridge to compress and clamp the tissueagainst the deck. Thereafter, staples removably stored in the cartridgebody can be deployed into the tissue. The cartridge body includes staplecavities defined therein wherein staples are removably stored in thestaple cavities. The staple cavities are arranged in six longitudinalrows. Three rows of staple cavities are positioned on a first side of alongitudinal slot and three rows of staple cavities are positioned on asecond side of the longitudinal slot. Other arrangements of staplecavities and staples are contemplated.

The staples are supported by staple drivers in the cartridge body. Thedrivers are movable between a first, or unfired, position and a second,or fired, position to eject the staples from the staple cavities. Thedrivers are retained in the cartridge body by a retainer which extendsaround the bottom of the cartridge body and includes resilient membersconfigured to grip the cartridge body and hold the retainer to thecartridge body. The drivers are movable between their unfired positionsand their fired positions by a sled. The sled is movable between aproximal position adjacent a proximal end of the cartridge body and adistal position adjacent a distal end of the cartridge body. The sledcomprises a plurality of ramped surfaces configured to slide under thedrivers and lift the drivers, and the staples supported thereon, towardthe anvil.

Further to the above, the sled is moved distally by a firing member. Thefiring member is configured to contact the sled and push the sled towardthe distal end. The longitudinal slot defined in the cartridge body isconfigured to receive the firing member. The anvil also includes a slotconfigured to receive the firing member. The firing member furthercomprises a first cam which engages the first jaw and a second cam whichengages the second jaw. As the firing member is advanced distally, thefirst cam and the second cam can control the distance, or tissue gap,between the deck of the staple cartridge and the anvil. The firingmember also comprises a knife configured to incise the tissue capturedintermediate the staple cartridge and the anvil. It is desirable for theknife to be positioned at least partially proximal to the rampedsurfaces such that the staples are ejected into the tissue ahead of theknife transecting the tissue.

FIGS. 1-8 depict a surgical stapling instrument 10 configured to clamp,staple, and cut tissue of a patient. The surgical stapling instrument 10comprises a handle 20, a shaft assembly 100 attached to the handle 20,and an end effector 200. To cut and staple tissue of a patient, the endeffector 200 comprises a cartridge jaw 201 and an anvil jaw 203. Theanvil jaw 203 is pivotable relative to the cartridge jaw 203 to clamptissue between the anvil jaw 203 and the cartridge jaw 203. Once tissueis clamped between the jaws 201, 203, the surgical stapling instrument10 may be actuated to advance a firing member through the jaws 201, 203to staple and cut tissue with the end effector 200 as discussed ingreater detail below.

Discussed in greater detail below, the end effector 200 is articulatableby way of an articulation region 110 of the shaft assembly 100. Sucharticulation provides a user of the surgical stapling instrument 10 withthe ability to position and/or maneuver the end effector 200 near thetarget tissue more accurately.

The handle 20 comprises a housing 21 configured to house variousmechanical and electrical components and a handle portion 22 extendingfrom the housing 21. The handle portion 22 is configured to fit in thepalm of a user and/or be gripped and/or held by a user using thesurgical stapling instrument 10. The handle 20 further comprises variousactuators and/or triggers configured to be actuated by a user to operateone or more functions of the surgical stapling instrument 10. The handle20 comprises a closure trigger 24, a firing trigger 25, and at least onearticulation actuator 26. When actuated by a user, the closure trigger24 is configured to clamp tissue with the end effector 200 by moving theanvil jaw 203 toward the cartridge jaw 201. When actuated by a user, thefiring trigger 25 is configured to cut and staple tissue with the endeffector 200 by advancing a firing member to eject staples and cuttissue with a knife. When actuated by a user, the articulation actuator26 is configured to articulate the end effector 200 relative to theshaft assembly 100 by way of the articulation region 110. The triggersand actuators of the surgical stapling instrument 10 can either triggerone or more motors within the handle 20 to actuate various function ofthe surgical stapling instrument 10 and/or manually drive various driveshafts and components to actuate various function of the surgicalstapling instrument 10.

The handle 20 further comprises a nozzle assembly 30 configured tosupport the shaft assembly 100 therein. The nozzle assembly 30 comprisesan actuation wheel 31 configured to be rotated by a user to rotate theshaft assembly 100 and end effector 200 about a longitudinal axis LArelative to the handle 20. Such a mechanism permits the user of thesurgical stapling instrument 10 to rotate only the shaft assembly 100and/or end effector 200 without having to rotate the entire handle 20.

The handle 20 further comprises a battery 23 configured to provide powerto various electronic components, sensors, and/or motors of the surgicalstapling instrument 10. Embodiments are envisioned where the surgicalstapling instrument 10 is directly connected to a power source.Embodiments are also envisioned where the surgical stapling instrument10 is entirely manual or, non-powered, for example. Embodiments arefurther envisioned where articulation of the end effector, clamping andunclamping of the jaws, firing of the end effector staple and cuttissue, and shaft and/or end effector rotation are all powered systems.

In at least one instance, the shaft assembly 100 and the end effector200 may be modular and removable from the handle 20. In at least oneinstance, the end effector 200 may be modular in that the end effector200 can be removed from the shaft assembly 100 and replaced with adifferent end effector. In at least one instance, the shaft assembly 100and/or the end effector 200 is employable in a surgical roboticenvironment. Such an embodiment would provide powered inputs from asurgical robotic interface to actuate each function of the end effector200. Examples of such surgical robots and surgical tools are furtherdescribed in U.S. Patent Application Publication No. 2020/0138534,titled ROBOTIC SURGICAL SYSTEM, which published on May 7, 2020, which isincorporated by reference herein in its entirety.

In at least one instance, the shaft assembly 100 and the end effector200 are configured to be used with a surgical robot. In such aninstance, the shaft assembly 100 and the end effector 200 are configuredto be coupled to a surgical robot comprising a plurality of outputdrives. The plurality of output drives of the surgical robot areconfigured to mate with the drive systems of the shaft assembly 100 andend effector 200. In such an instance, the surgical robot can actuatethe various different functions of the end effector 200 such as, forexample, articulating the end effector about multiple differentarticulation joints, rotating the shaft assembly 100 and/or end effector200 about its longitudinal axis, clamping the end effector 200 to clamptissue between the jaws of the end effector 200, and/or firing the endeffector 200 to cut and/or staple tissue.

The shaft assembly 100 is configured to house various drive systemcomponents and/or electronic components of the surgical staplinginstrument 10 so that the end effector 200 and shaft assembly 100 may beinserted through a trocar for laparoscopic surgery. The various drivesystem components are configured to be actuated by the various triggersand actuators of the handle 20. Such components can include drive shaftsfor articulation, drive shafts for clamping and unclamping the endeffector 200, and/or drive shafts for firing the end effector 200. Suchdrive shafts may be rotated by a drive system in the handle 20 or asurgical robotic interface in the instance where the shaft assembly 100is connected to the same. In various aspects, a stapling end effectorcan include two independently rotatable drive members—one for graspingtissue and one for firing staples, for example. The stapling endeffector can further include an articulation joint, and the rotarymotions can be transmitted through the articulation joint. In variousaspects, the stapling end effector can include one or more 3D printedassemblies, which can be incorporated into an articulation, grasping, orfiring systems.

Such drive shafts may be actuated by a drive system in the handle 20 ora surgical robotic interface in the instance where the shaft assembly100 is connected to the same. Such drive shafts may comprise linearactuation, rotary actuation, or a combination thereof. A combination ofrotary actuation and linear actuation may employ a series of rack gearsand/or drive screws, for example. In at least one instance, the shaftassembly 100 is also configured to house electrical leads for varioussensors and/or motors, for example, positioned within the shaft assembly100 and/or end effector 200, for example.

The shaft assembly 100 comprises an outer shaft 101 extending from thenozzle assembly 30 to the articulation region 110 comprising dualarticulation joints, discussed in greater detail below. The articulationregion 110 allows the end effector 200 to be articulated relative to theouter shaft 101 in two distinct planes about two separate axes AA1, AA2.

Referring now primarily to FIG. 4, articulation of the end effector 200will now be described. The articulation region 110 comprises twodistinct articulation joints and two articulation actuators 150, 160.This allows the end effector 200 to be articulated in two differentplanes about two different axes AA1, AA2 independently of each other.The articulation region 110 comprises a proximal joint shaft component120, an intermediate joint shaft component 130, and a distal joint shaftcomponent 140. The proximal joint shaft component 120 is attached to adistal end of the shaft assembly 100, the intermediate joint shaftcomponent 130 is pivotally connected to the proximal joint shaftcomponent 120 and the distal joint shaft component 140, and the distaljoint shaft component 140 is fixedly attached to the end effector 200 byway of a retention ring 146. Discussed in greater detail below, thisarrangement provides articulation of the end effector 200 relative tothe shaft assembly 100 about axis AA1 and axis AA2 independently of eachother.

The proximal joint shaft component 120 comprises a proximal annularportion 121 fixedly fitted within the outer shaft 101. The proximaljoint shaft component 120 also includes a hollow passage 122 to allowvarious drive system components to pass therethrough, and furtherincludes an articulation tab 123 comprising a pin hole 124 configured toreceive articulation pin 125. The articulation pin 125 pivotallyconnects the proximal joint shaft component 120 to a proximalarticulation tab 131 of the intermediate joint shaft component 130. Toarticulate the end effector 200 about axis AA1, the articulationactuator 150 is actuated linearly either in a distal direction or aproximal direction. Such an actuator may comprise a bar or rod made ofany suitable material such as metal and/or plastic, for example. Thearticulation actuator 150 is pivotally mounted to an articulationcrosslink 151. The articulation crosslink 151 is pivotally mounted tothe intermediate joint shaft component 130 off-axis relative to thearticulation pin 125 so that when the articulation actuator 150 isactuated, a torque is applied to the intermediate joint shaft component130 off-axis relative to the articulation pin 125 by the articulationcrosslink 151 to cause the intermediate joint shaft component 130 and,thus, the end effector 200, to pivot about axis AA1 relative to theproximal joint shaft component 120.

The intermediate joint shaft component 130 is pivotally connected to theproximal joint shaft component 120 by way of the articulation pin 125which defines axis AA1. Specifically, the intermediate joint shaftcomponent 130 comprises a proximal articulation tab 131 that ispivotally connected to the proximal joint shaft component 120 by way ofthe articulation pin 125. The intermediate joint shaft component 130further comprises a hollow passage 132 configured to allow various drivesystem components to pass therethrough and a distal articulation tab133. The distal articulation tab 133 comprises a pin hole 134 configuredto receive another articulation pin 136, which defines axis AA2, and adistally-protruding key 135.

To articulate the end effector 200 about axis AA2, the articulationcable 160 is actuated to apply an articulation torque to a proximal tab141 of the distal joint shaft component 140 by way of the key 135. Thearticulation cable 160 is fixed to the key 135 such that, as the cable160 is rotated, the key 135 is pivoted relative to the intermediatejoint shaft component 130. The key 135 is fitted within a key hole 144of the distal joint shaft component 140. Notably, the key 135 is notfixed to the intermediate joint shaft component 130 and the key 135 canbe rotated relative to the intermediate joint shaft component 130. Thearticulation cable 160 also contacts the proximal tab 141 around the pinhole 142. This provides an additional torque moment from thearticulation cable 160 to the distal joint shaft component 140. Thearticulation pin 136 is received within the pin hole 142 to pivotallycouple the intermediate joint shaft component 130 and the distal jointshaft component 140.

In at least one instance, the articulation cable 160 is only able to bepulled in a proximal direction. In such an instance, only one side ofthe articulation cable 160 would be pulled proximally to articulate theend effector 200 in the desired direction. In at least one instance, thearticulation cable 160 is pushed and pulled antagonistically. In otherwords, the cable 160 can comprise a rigid construction such that oneside of the articulation cable 160 is pushed distally while the otherside of the articulation cable 160 is pulled proximally. Such anarrangement can allow the articulation forces to be divided between thepushed half of the cable 160 and the pulled half of the cable 160. In atleast one instance, the push-pull arrangement allows greaterarticulation forces to be transmitted to the corresponding articulationjoint. Such forces may be necessary in an arrangement with twoarticulation joints. For example, if the proximal articulation joint isfully articulated, more force may be required of the articulationactuator meant to articulate the distal articulation joint owing to thestretching and/or lengthened distance that the articulation actuator forthe distal articulation joint must travel.

The distal joint shaft component 140 further comprises a cutout 143 toallow various drive components to pass therethrough. The retention ring146 secures a channel 210 of the cartridge jaw 201 to the distal jointshaft component 140 thereby fixing the end effector assembly 200 to adistal end of the articulation region 110.

As discussed above, the anvil jaw 201 is movable relative to thecartridge jaw 203 to clamp and unclamp tissue with the end effector 200.Operation of this function of the end effector 200 will now bedescribed. The cartridge jaw 201 comprises the channel 210 and a staplecartridge 220 configured to be received within a cavity 214 of thechannel 210. The channel 210 further comprises an annular groove 211configured to receive the retention ring 146 and a pair of pivot holes213 configured to receive a jaw-coupling pin 233. The jaw coupling pin233 permits the anvil jaw 203 to be pivoted relative to the cartridgejaw 201.

The anvil jaw 203 comprises an anvil body 230 and a pair of pivot holes231. The pivot holes 231 in the proximal portion of the anvil jaw 203are configured to receive the jaw-coupling pin 233 thereby pivotallycoupling the anvil jaw 203 to the cartridge jaw 201. To open and closethe anvil jaw 203 relative to the cartridge jaw 201, a closure drive 250is provided.

The closure drive 250 is actuated by a flexible drive segment 175comprised of universally-movable joints arranged or formed end-to-end.In various instances, the flexible drive segment 175 can includes serial3D-printed universal joints, which are printed all together as a singlecontinuous system. Discussed in greater detail below, the flexible drivesegment 175 is driven by an input shaft traversing through the shaftassembly 100. The flexible drive segment 175 transmits rotary actuationmotions through the dual articulation joints. The closure drive 250comprises a closure screw 251 and a closure wedge 255 threadably coupledto the closure screw 251. The closure wedge 255 is configured topositively cam the anvil jaw 203 open and closed. The closure screw 251is supported by a first support body 258 and a second support body 259secured within the channel 210.

To move the anvil jaw 203 between a clamped position (FIG. 8) and anunclamped position (FIG. 7), a closure drive shaft is actuated toactuate the flexible drive segment 175. The flexible drive segment 175is configured to rotate the closure screw 251, which displaces theclosure wedge 255. For example, the closure wedge 255 is threadablycoupled to the closure screw 251 and rotational travel of the closurewedge 255 with the staple cartridge 220 is restrained. The closure screw251 drives the closure wedge 255 proximally or distally depending onwhich direction the closure screw 251 is rotated.

To clamp the end effector 200 from an unclamped position (FIG. 7), theclosure wedge 255 is moved proximally. As the closure wedge 255 is movedproximally, a proximal cam surface 256 of the closure wedge 255 contactsa corresponding cam surface 234 defined in a proximal end 235 of theanvil body 230. As the cam surface 256 contacts the cam surface 234, aforce is applied to the proximal end 235 of the anvil body 230 causingthe anvil body 230 to rotate into the clamped position (FIG. 8) aboutthe pin 233.

To open or unclamp the end effector 200 from a clamped position (FIG.8), the closure wedge 255 is moved distally by rotating the closurescrew 251 in a direction opposite to the direction that causes theclosure wedge 255 to move proximally. As the closure wedge 255 is moveddistally, a pair of nubs 257 extending from a distal end of the closurewedge 255 contact the cam surface 234 near a downwardly extending tab237 of the anvil body 230. As the nubs 257 contact the cam surface 234near the tab 237, a force is applied to the anvil body 230 to rotate theanvil body 230 into the open position (FIG. 7) about the pin 233.

In at least one instance, the profile of the cam surface 234 correspondsto the profile of the cam surface 256. For example, the cam surface 234and the cam surface 256 may match such that a maximum cam force isapplied to the anvil body 230 to cause the desired rotation of the anvilbody 230. As can be seen in FIG. 8, for example, the cam surface 234defined by the proximal end 235 of the anvil body 230 comprises a rampedsection similar to that of the upper ramped section of the cam surface256.

As discussed above, the surgical stapling instrument 10 may be actuatedto advance a firing member through the jaws 201, 203 to staple and cuttissue with the end effector 200. The function of deploying staples 226from the staple cartridge 220 and cutting tissue with knife 283 will nowbe described. The staple cartridge 220 comprises a cartridge body 221, aplurality of staple drivers 225, and a plurality of staples 226removably stored within the cartridge body 221. The cartridge body 221comprises a deck surface 222, a plurality of staple cavities 223arranged in longitudinal rows defined in the cartridge body 221, and alongitudinal slot 224 bifurcating the cartridge body 221. The knife 283is configured to be driven through the longitudinal slot 224 to cuttissue clamped between the anvil body 230 and the deck surface 221.

The deck surface 221 comprises a laterally-contoured tissue-supportingsurface. In various aspects, the contour of the deck surface 221 canform a peak along a central portion of the cartridge body 221. Such apeak can overlay a longitudinally-extending firing screw 261 thatextends through the central portion of the cartridge body 221, which isfurther described herein. The increased height along the peak can beassociated with a smaller tissue gap along a firing path of the knife283 in various instances. In certain aspects of the present disclosure,driver heights, formed staple heights, staple pocket extension heights,and/or staple overdrive distances can also vary laterally along the decksurface 221. Laterally-variable staple formation (e.g. a combination of2D staples and 3D staples) is also contemplated and further describedherein.

The staple drivers 225 are configured to be lifted by a sled 280 as thesled 280 is pushed distally through the staple cartridge 220 to ejectthe staples 226 supported by the staple drivers 225 in the staplecavities 223. The sled 280 comprises ramps 281 to contact the stapledrivers 225. The sled 280 also includes the knife 283. The sled 280 isconfigured to be pushed by a firing member 270.

To deploy the staples 226 and cut tissue with the knife 283, the endeffector 200 comprises a firing drive 260. The firing drive 260 isactuated by a flexible drive shaft 176. Discussed in greater detailbelow, the flexible drive shaft 176 is driven by an input shafttraversing through the shaft assembly 100. The flexible drive shaft 176transmits rotary actuation motions through the dual articulation joints.The firing drive 260 comprises a firing screw 261 configured to berotated by the flexible drive shaft 176. The firing screw 261 comprisesjournals supported within bearings in the support member 259 and thechannel 210. In various instances, the firing screw 261 can floatrelative to the channel 210, as further described herein. The firingscrew 261 comprises a proximal end 262 supported within the supportmember 259 and the channel 210, a distal end 263 supported within thechannel 210, and threads 265 extending along a portion of the length ofthe firing screw 261.

The firing member 270 is threadably coupled to the firing screw 261 suchthat as the firing screw 261 is rotated, the firing member 270 isadvanced distally or retracted proximally along the firing screw 261.Specifically, the firing member 270 comprises a body portion 271comprising a hollow passage 272 defined therein. The firing screw 261 isconfigured to be received within the hollow passage 272 and isconfigured to be threadably coupled with a threaded component 273 of thefiring member 270. Thus, as the firing screw 261 is rotated, thethreaded component 273 applies a linear force to the body portion 271 toadvance the firing member 270 distally or retract the firing member 270proximally. As the firing member 270 is advanced distally, the firingmember 270 pushes the sled 280. Distal movement of the sled 280 causesthe ejection of the staples 223 by engaging the plurality of stapledrivers 225, as further described herein. The driver 225 is a tripledriver, which is configured to simultaneously fire multiple staples 223.The driver 225 can comprise lateral asymmetries, as further describedherein, to maximum the width of the sled rails and accommodate thefiring screw 261 down the center of the cartridge 220 in variousinstances.

At a point during firing of the end effector 200, a user may retract thefiring member 270 to allow unclamping of the jaws 201, 203. In at leastone instance, the full retraction of the firing member 270 is requiredto open the jaws 201, 203 where upper and lower camming members areprovided on the body portion 271 which can only be disengaged from thejaws 201, 203 once the firing member 270 is fully retracted.

In various instances, the firing member 270 can be a hybrid constructionof plastic and metal portions as further described herein. In variousinstances, the threaded component 273 can be a metal component, forexample, which is incorporated into the firing member body 271 withinsert molding or over molding.

The firing member 270 can also be referred to an I-beam in certaininstances. The firing member 270 can include a complex 3D-printedgeometry comprising a lattice pattern of spaces therein. In variousinstances, 3D printing can allow the firing member or a portion thereofto act as a spring and allows a portion to more readily flex, which canimprove the force distribution and/or tolerances during a firing stroke,for example.

FIGS. 9-11 depict a surgical stapling assembly 300 comprising a shaftassembly 310 and the end effector 200 of FIGS. 1-8 attached to the shaftassembly 310. The shaft assembly 310 may be similar in many respects tovarious other shaft assemblies discussed herein; however, the shaftassembly 310 comprises a single articulation joint and an articulationbar configured to articulate the end effector 200 about the singlearticulation joint. The surgical stapling assembly 300 is configured tocut and staple tissue. The surgical stapling assembly 300 may beattached to a surgical instrument handle and/or surgical roboticinterface. The surgical instrument handle and/or surgical roboticinterface can be configured to actuate various functions of the surgicalstapling assembly 300. The shaft assembly 310 comprises an articulationjoint 320. Discussed in greater detail below, the end effector 200 isconfigured to be articulated relative to an outer shaft 311 of the shaftassembly 310 about axis AA.

The shaft assembly 310 comprises the outer shaft 311, a first shaftjoint component 330, and a second shaft joint component 350 pivotallycoupled to the first shaft joint component 330 by way of an articulationpin 354. The first shaft joint component 330 comprises a proximal tubeportion 331 configured to fit within the inner diameter of the outershaft 311. Such a fit may comprise a press fit, for example. However,any suitable attachment means can be used. The first shaft jointcomponent 330 also includes a distal portion 332. The distal portion 332comprises an articulation tab 333 comprising a pin hole 334 definedtherein and a hollow passage 335 through which various drive componentsof the surgical stapling assembly 300 can pass. Such drive componentscan include articulation actuators, closure actuators, and/or firingactuators for example.

The first shaft joint component 330 is pivotally connected to the secondshaft joint component 350 by way of the articulation pin 354. Thearticulation pin 354 is also received within a pin hole 353 of aproximally-extending articulation tab 351 of the second shaft jointcomponent 350. The pin hole 353 is axially aligned with the pin hole334. The articulation pin 354 allows the second shaft joint component350 to be articulated relative to the first shaft joint component 330about the articulation axis AA. The second shaft joint component 350further comprises a pin protrusion 352 extending from theproximal-extending articulation tab 351. Discussed in greater detailbelow, the pin protrusion 352 is configured to be pivotally coupled toan articulation drive system. The second shaft joint component 350further comprises a distal portion 355 comprising an annular groove 356configured to receive a retention ring 358. The distal portion 355 alsoincludes a hollow passage 357 through which various drive components ofthe surgical stapling assembly 300 can pass. The retention ring 358 isconfigured to hold the first jaw 201 to the second shaft joint component350 by fitting within the annular groove 211 of the cartridge channel210 and the annular groove 356 of the second shaft joint component 350.

To articulate the end effector 200 about the articulation axis AA, anarticulation bar 360 is provided. The articulation bar 360 may beactuated by any suitable means such as, for example, by a robotic ormotorized input and/or a manual handle trigger. The articulation bar 360may be actuated in a proximal direction and a distal direction, forexample. Embodiments are envisioned where the articulation systemcomprises rotary driven actuation in addition to or, in lieu of, linearactuation. The articulation bar 360 extends through the outer shaft 311.The articulation bar 360 comprises a distal end 361 pivotally coupled toan articulation link 362. The articulation link 362 is pivotally coupledto the pin protrusion 352 extending from the proximally-extendingarticulation tab 351 off center with respect to the articulation axisAA. Such off-center coupling of the articulation link 362 allows thearticulation bar 360 to apply a force to the second joint shaftcomponent 350 to rotate the second shaft joint component 350 and, thus,the end effector 200, relative to the first joint shaft component 330.The articulation bar 360 can be advanced distally to rotate the endeffector 200 in a first direction about the articulation axis AA andretracted proximally to rotate the end effector 200 in a seconddirection opposite the first direction about the articulation axis AA.

The shaft assembly 310 further comprises an articulation componentsupport structure 340 positioned within the articulation joint 320. Sucha support structure can provide support to various drive componentsconfigured to pass through the articulation joint 320 to the endeffector 200 as the end effector 200 is articulated. The supportstructure 340 may also serve to isolate the drive components from tissueremnants during use.

FIGS. 12-14 depict a surgical stapling assembly 400 comprising a shaftassembly 410 and the end effector 200 of FIGS. 1-8 attached to the shaftassembly 410. The shaft assembly 410 may be similar in many respects tovarious other shaft assemblies discussed herein; however, the shaftassembly 410 comprises a single articulation joint and an articulationcable configured to articulate the end effector 200 about the singlearticulation joint. The surgical stapling assembly 400 is configured tocut and staple tissue. The surgical stapling assembly 400 may beattached to a surgical instrument handle and/or surgical roboticinterface. The surgical instrument handle and/or surgical roboticinterface can be configured to actuate various functions of the surgicalstapling assembly 400. The shaft assembly 410 comprises an articulationjoint 420. Discussed in greater detail below, the end effector 200 isconfigured to be articulated relative to an outer shaft 411 of the shaftassembly 310 about an axis AA.

The shaft assembly 410 comprises the outer shaft 411, a first shaftjoint component 430, and a second shaft joint component 450 pivotallycoupled to the first shaft joint component 430 by way of an articulationpin 454. The first shaft joint component 430 comprises a proximal tubeportion 431 configured to fit within the inner diameter of the outershaft 411. Such a fit may comprise a press fit, for example. However,any suitable attachment means can be used. The first shaft jointcomponent 430 also includes a distal portion 432, which comprises anarticulation tab 433 comprising a pin hole 434 defined therein. Thedistal portion 432 further defines a hollow passage 435 through whichvarious drive components of the surgical stapling assembly 400 can pass.Such drive components can include articulation actuators, closureactuators, and/or firing actuators, for example.

The first shaft joint component 430 is pivotally connected to the secondshaft joint component 450 by way of the articulation pin 454. Thearticulation pin 454 is also received within a pin hole 453 of aproximally-extending articulation tab 451 of the second shaft jointcomponent 450. The articulation pin 454 allows the second shaft jointcomponent 450 to be articulated relative to the first shaft jointcomponent 430 about the articulation axis AA. The second shaft jointcomponent 450 further comprises a drive ring structure 452. The drivering structure 452 extends from the proximally-extending articulationtab 451 and further defines a portion of the pin hole 453. Discussed ingreater detail below, the drive ring structure 452 is configured to beengaged by an articulation drive system. The second shaft jointcomponent 450 further comprises a distal portion 455 comprising anannular groove 456 configured to receive a retention ring 458. A hollowpassage 457 through the distal portion 455 is configured to receivevarious drive components of the surgical stapling assembly 400therethrough. The retention ring 458 is configured to hold the first jaw201 to the second shaft joint component 450 by fitting within theannular groove 211 of the cartridge channel 210 and the annular groove456 of the second shaft joint component 450.

To articulate the end effector 200 about the articulation axis AA, anarticulation cable 460 is provided. The articulation cable 460 may beactuated by any suitable means such as, for example, by a robotic inputand/or a manual trigger on a handle of a handheld surgical instrument.The articulation cable 460 may comprise an antagonistic actuationprofile. In other words, as a first side of the articulation cable 460is pulled proximally a second side of the articulation cable 460 isallowed to advance distally like a pulley system. Similarly, as thesecond side is pulled proximally, the first side is allowed to advancedistally. The articulation cable 460 extends through the outer shaft411. The articulation cable 460 is positioned around the drive ringstructure 452 and frictionally retained thereon to permit rotation ofthe second shaft joint component 450 as the articulation cable 460 isactuated. As the articulation cable 460 is actuated, the articulationcable 460 is configured to apply a rotational torque to the drive ringstructure 452 of the second joint shaft component 450 and, thus, the endeffector 200. Such torque is configured to cause the second joint shaftcomponent 450 to rotate, or pivot, relative to the first joint shaftcomponent 430 thereby articulating the end effector 200 relative to theouter shaft 411. A first side of the articulation cable 460 can pulledto rotate the end effector 200 in a first direction about thearticulation axis AA and a second side of the articulation cable 460 canbe pulled to rotate the end effector 200 in a second direction oppositethe first direction about the articulation axis AA.

The shaft assembly 410 further comprises an articulation componentsupport structure 440 positioned within the articulation joint 420. Sucha support structure 440 can provide support to various drive componentsconfigured to pass through the articulation joint 420 to the endeffector 200 as the end effector 200 is articulated. The supportstructure 440 may also serve to isolate the drive components from tissueremnants during use.

The surgical stapling assembly 400 further comprises a closure driveshaft segment 475 and a firing drive shaft segment 476 each configuredto transmit rotary motion through the articulation joint 420 to the endeffector 200. The drive shaft segments 475, 476 are configured topassively expand and contract longitudinally as the end effector 200 isarticulated. For example, articulation can cause expansion andcontraction of the drive shaft segments 475, 476 to account for therespective longitudinal stretching of or contracting of the length ofthe drive shafts owing to articulation of the end effector 200 relativeto the shaft assembly 410. During expansion and contraction of the driveshaft segments 475, 476, the drive shaft segments 475, 476 maintainrotary driving engagement with corresponding input shafts extendingthrough the outer shaft 411 and output shafts in the end effector 200.In at least one instance, the output shafts comprise the closure screw251, which is configured to effect grasping, closing, or tissuemanipulation with the jaws 201, 203, and the firing screw 261, which isconfigured to effect clamping of the jaws 201, 203 and firing of thefiring member 270.

FIGS. 15-17 depict a surgical stapling assembly 500 comprising a shaftassembly 510 and the end effector 200 of FIGS. 1-8 attached to the shaftassembly 510. The shaft assembly 510 may be similar in many respects tovarious other shaft assemblies discussed herein; however, the shaftassembly 510 comprises a single articulation joint and drive shaftsegments configured to passively expand and contract. The surgicalstapling assembly 500 is configured to cut and staple tissue. Thesurgical stapling assembly 500 may be attached to a surgical instrumenthandle and/or surgical robotic interface. The surgical instrument handleand/or surgical robotic interface can be configured to actuate variousfunctions of the surgical stapling assembly 500. The shaft assembly 510comprises an articulation joint 520. Discussed in greater detail below,the end effector 200 is configured to be articulated about an axis AA.

The shaft assembly 510 comprises a first shaft joint component 530 and asecond shaft joint component 540 pivotally coupled to the first shaftjoint component 530 by way of an articulation pin 543. The first shaftjoint component 530 is configured to be attached to a shaft of asurgical instrument assembly and/or a surgical robotic interface. Thefirst shaft joint component 530 comprises a proximal portion 531 and anarticulation tab 533 comprising a pin hole 534 defined therein. In atleast one instance, the first shaft joint component 530 comprises ahollow passage through which various drive components of the surgicalstapling assembly 400 can pass. Such drive components can includearticulation actuators, closure actuators, and/or firing actuators forexample.

The first shaft joint component 530 is pivotally connected to the secondshaft joint component 540 by way of the articulation pin 543. Thearticulation pin 543 is also received within a pin hole 542 of aproximally-extending articulation tab 541 of the second shaft jointcomponent 540. The articulation pin 543 allows the second shaft jointcomponent 540 to be articulated relative to the first shaft jointcomponent 530 about the articulation axis AA. The second shaft jointcomponent 540 further comprises a distal portion 545 comprising anannular groove 547 configured to receive a retention ring 548 and ahollow passage 546 through which various drive components of thesurgical stapling assembly 500 can pass. The retention ring 548 isconfigured to hold the first jaw 201 to the second shaft joint component540 by fitting within the annular groove 211 of the cartridge channel210 and the annular groove 547 of the second shaft joint component 540.

Any suitable articulation drive system can be used to articulate the endeffector 200 about axis AA. In at least one instance, the end effector200 is passively articulated. In such an instance, the end effector 200may be pressed against tissue, for example, to apply a force to the endeffector 200 and cause the end effector 200 to articulate about anarticulation axis. In at least one instance, the end effector 200further comprises a spring configured to apply a neutral biasing forceto the second shaft joint segment 540, for example, to cause the endeffector 200 to be biased toward an unarticulated configuration.

The surgical stapling assembly 500 further comprises a closure driveshaft segment 575 and a firing drive shaft segment 576 each configuredto transmit rotary motion through the articulation joint 520 to the endeffector 200. The drive shaft segments 575, 576 are configured topassively expand and contract longitudinally as the end effector 200 isarticulated. Articulation causes the drive shaft segments 575, 576 toexpand and contract to account for the longitudinal stretching of orcontracting of the length of the drive shafts owing to articulation ofthe end effector 200. During expansion and contraction of the driveshaft segments 575, 576, the drive shaft segments 575, 576 maintainrotary driving engagement with corresponding input shafts and outputshafts in the end effector 200. In at least one instance, the outputshafts comprise the closure screw 251 and the firing screw 261, whichare further described herein.

FIGS. 18-20 depict a surgical stapling end effector assembly 600comprising a shaft portion 610 and an end effector 600. The end effectorassembly 600 is similar in many respects to various other end effectorassemblies disclosed herein; however, the end effector assembly 600comprises a multi-component firing member driven by a flexible firingshaft. The end effector assembly 600 is configured to cut and stapletissue. The end effector assembly 600 may be attached to a surgicalinstrument handle and/or surgical robotic interface by way of a proximaltab 611 of the shaft portion 610. The surgical instrument handle and/orsurgical robotic interface can be configured to actuate variousfunctions of the end effector assembly 600. The end effector assembly600 comprises a cartridge channel jaw 620 and an anvil jaw 660 pivotallymounted to the cartridge channel jaw 620 to clamp tissue between thecartridge channel jaw 620 and the anvil jaw 660.

The cartridge channel jaw 620 comprises a channel 630 comprising aproximal end 631, a staple cartridge 640 configured to store a pluralityof staples therein and configured to be received within the channel 630,and a support brace 650 fitted within the staple cartridge 640. Thestaple cartridge 640 and the support brace 650 are configured to beassembled together prior to installing the staple cartridge 640 into thechannel 630. Discussed in greater detail below, the support brace 650 isconfigured to further support a firing member assembly as the firingmember assembly is advanced through the end effector assembly 600.

The anvil jaw 660 is configured to form staples ejected from the staplecartridge 640. The anvil jaw 660 comprises a proximal end 661 comprisinga pair of pin holes 662 defined therein configured to receive a couplingpin 663. The anvil jaw 660 is pivotable about the coupling pin 663between an unclamped position and a fully clamped position. The couplingpin 663 is also received within a pair of pin holes 633 defined in theproximal end 631 of the channel 630. The coupling pin 663 serves topivotally mount the anvil jaw 660 to the channel 630. In at least oneinstance, the channel 630 is mounted to the shaft portion 610 by way ofa retention ring, or band, that fits around an annular groove 632 of thechannel 630 and annular groove 615 of the shaft portion 610. Theretention ring, or band, is configured to hold the channel 630 to theshaft portion 610.

The end effector assembly 600 comprises a closure drive 670 configuredto grasp tissue between the anvil jaw 660 and the cartridge channel jaw620 by pivoting the anvil jaw 660 relative to the channel 630. The endeffector assembly 600 also includes a firing drive 680 configured toclamp, staple, and cut tissue by deploying a plurality of staples fromthe staple cartridge 640. The closure drive 670 comprises a closurescrew 671 positioned within the channel 630 and a closure wedge 675threadably coupled to the closure screw 671. As the closure screw 671 isrotated, the closure wedge 675 is advanced distally or retractedproximally to open or close the anvil jaw 660, respectively. The closuredrive 670 may be actuated by any suitable means. For example, a rotarydrive shaft may extend through the shaft portion 610 from an actuationinterface, for example, to rotate the closure screw 671. Other examplesof suitable rotary drive shafts are further described herein.

The firing drive 680 comprises a flexible drive shaft 681 that isconfigured to be moved linearly through the end effector assembly 600.The flexible drive shaft 681 may be actuated by a robotic input and/or amanually-actuated drive shaft of a handle assembly, for example. Theflexible drive shaft 681 is configured to extend through a hollowpassage 614 of a distal end 613 of the shaft portion 610 and is flexibleso that the end effector assembly 600 may be articulated relative to ashaft from which the end effector 600 extends. The flexible drive shaft681 extends through a clearance slot 676 defined in the closure wedge675 and is fixedly attached to a lower firing member 682. The lowerfiring member 682 is configured to be reused with different staplecartridges.

The staple cartridge 640 comprises a disposable upper firing member 683configured to hookingly engage or, latch, onto the lower firing member682 such that the lower firing member 582 can push or, drive, the upperfiring member 683 through the staple cartridge 640 and support brace650. In other words, the firing actuation involves a two-part firingmember—a disposable upper firing member 683 incorporated into thecartridge 640 and a reusable lower firing member 682 incorporated intothe firing drive 680, which can be coupled together when the cartridge640 is seated in the elongate channel 630. The two-part firing member isfurther described herein.

The upper firing member 683 comprises an upper flange configured toengage and position the anvil jaw 660, a knife edge configured to cuttissue, and a latch portion configured to hookingly engage the lowerfiring member 682. The staple cartridge 640 further comprises a sled 684configured to engage staple drivers positioned within the staplecartridge 640 to eject staples from the staple cartridge 640. Because aknife and cutting edge are incorporated into the disposable upper firingmember 683 of the staple cartridge 640, a new and/or fresh cutting edgecan be supplied with each staple cartridge loaded into the end effectorassembly 600.

The lower firing member 682 and the upper firing member 683 areconfigured to move through the support brace 650 such that the verticalloads associated with the firing sequence are configured to bedistributed through the support brace 650, the staple cartridge 640, thechannel 630, and the anvil jaw 660. The support brace 650 may becomprised of a metal material, for example, to be inserted within thestaple cartridge 640. The support brace 650 comprises key rails 655configured to fit within corresponding key slots defined in alongitudinal slot of the staple cartridge 640. The support brace 650further comprises a longitudinal slot 653 configured to receive theknife of the upper firing member 683, a cylindrical passage 657configured to receive a portion of the upper firing member 683, aportion of the lower firing member 682, and the flexible drive shaft681. The support brace 650 further comprises vertical key extensions 656configured to be received within corresponding key holes in thecartridge deck. Such extensions may be visible through the cartridgedeck when the support brace 650 is installed within the staple cartridge640. In at least one instance, the support brace 650 is configured to beinserted into the staple cartridge 640 from the bottom of the staplecartridge 640 facing the channel 630.

The support brace 650 further comprises a proximal tab 651 and a distaltab 653, which are both configured to be engaged with the channel 630.The tabs 651, 653 are configured to distribute at least some of theforces transmitted through the assembly 600 by the firing drive 680 andcorresponding components. The distal tab 651 may serve to block theupper and lower firing members 683, 682 from being pushed through adistal end of the support brace 650 by sharing and/or redistributing theload applied to the support brace 650 by the firing drive 680 with thechannel 630.

When the staple cartridge 640 is replaced so that the end effectorassembly 600 can be reused, the staple cartridge 640 is removed from thechannel jaw 630. Removing the staple cartridge 640 from the channel jaw630 removes the upper firing member 683, the sled 684, the support brace650, and the staple cartridge 640. A fresh knife can be provided with areplacement staple cartridge.

Various embodiments disclosed herein may be employed in connection witha robotic system 700. An exemplary robotic system is depicted in FIGS.21-23, for example. FIG. 21 depicts a master controller 701 that may beused in connection with a surgical robot, such as the robotic arm slavecart 800 depicted in FIG. 22, for example. Master controller 701 androbotic arm slave cart 800, as well as their respective components andcontrol systems are collectively referred to herein as a robotic system700. Examples of such systems and devices are disclosed in U.S. Pat. No.7,524,320, entitled MECHANICAL ACTUATOR INTERFACE SYSTEM FOR ROBOTICSURGICAL TOOLS, as well as U.S. Pat. No. 9,072,535, entitled SURGICALSTAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS,which are each hereby incorporated by reference herein in theirrespective entireties. As is known, the master controller 701 generallyincludes controllers (generally represented as 703 in FIG. 21) which aregrasped by the surgeon and manipulated in space while the surgeon viewsthe procedure via a stereo display 702. The controllers 701 generallycomprise manual input devices which preferably move with multipledegrees of freedom, and which often further have an actuatable handle,trigger, or actuator for actuating tools (for example, for closinggrasping jaws, applying an electrical potential to an electrode, or thelike).

As can be seen in FIG. 22, in one form, the robotic arm cart 800 may beconfigured to actuate one or more surgical tools, generally designatedas 900. Various robotic surgery systems and methods employing mastercontroller and robotic arm cart arrangements are disclosed in U.S. Pat.No. 6,132,368, entitled MULTI-COMPONENT TELEPRESENCE SYSTEM AND METHOD,the entire disclosure of which is hereby incorporated by referenceherein.

In various forms, the robotic arm cart 800 includes a base 702 fromwhich, in the illustrated embodiment, surgical tools 900 may besupported. In various forms, the surgical tool(s) 900 may be supportedby a series of manually articulatable linkages, generally referred to asset-up joints 804, and a robotic manipulator 806. In variousembodiments, the linkage and joint arrangement may facilitate rotationof a surgical tool around a point in space, as more fully described inU.S. Pat. No. 5,817,084, entitled REMOTE CENTER POSITIONING DEVICE WITHFLEXIBLE DRIVE, the entire disclosure of which is hereby incorporated byreference herein. The parallelogram arrangement constrains rotation topivoting about an axis 812a, sometimes called the pitch axis. The linkssupporting the parallelogram linkage are pivotally mounted to set-upjoints 804 (FIG. 22) so that the surgical tool further rotates about anaxis 812b, sometimes called the yaw axis. The pitch and yaw axes 812a,812b intersect at the remote center 814, which is aligned along anelongate shaft of the surgical tool 900. The surgical tool 900 may havefurther degrees of driven freedom as supported by the manipulator 806,including sliding motion of the surgical tool 900 along the longitudinalaxis “LT-LT”. As the surgical tool 900 slides along the tool axis LT-LTrelative to manipulator 806 (arrow 812c), the remote center 814 remainsfixed relative to the base 816 of the manipulator 806. Hence, the entiremanipulator is generally moved to re-position the remote center 814.Linkage 808 of manipulator 806 may be driven by a series of motors 820.These motors actively move linkage 808 in response to commands from aprocessor of a control system. The motors 820 may also be employed tomanipulate the surgical tool 900. Alternative joint structures and setup arrangements are also contemplated. Examples of other joint and setup arrangements, for example, are disclosed in U.S. Pat. No. 5,878,193,entitled AUTOMATED ENDOSCOPE SYSTEM FOR OPTIMAL POSITIONING, the entiredisclosure of which is hereby incorporated by reference herein.

While the data communication between a robotic component and theprocessor of the robotic surgical system is primarily described hereinwith reference to communication between the surgical tool and the mastercontroller 701, it should be understood that similar communication maytake place between circuitry of a manipulator, a set-up joint, anendoscope or other image capture device, or the like, and the processorof the robotic surgical system for component compatibility verification,component-type identification, component calibration (such as off-set orthe like) communication, confirmation of coupling of the component tothe robotic surgical system, or the like. In accordance with at leastone aspect, various surgical instruments disclosed herein may be used inconnection with other robotically-controlled or automated surgicalsystems and are not necessarily limited to use with the specific roboticsystem components shown in FIGS. 21-23 and described in theaforementioned references. It is common practice during variouslaparoscopic surgical procedures to insert a surgical end effectorportion of a surgical instrument through a trocar that has beeninstalled in the abdominal wall of a patient to access a surgical sitelocated inside the patient's abdomen. In its simplest form, a trocar isa pen-shaped instrument with a sharp triangular point at one end that istypically used inside a hollow tube, known as a cannula or sleeve, tocreate an opening into the body through which surgical end effectors maybe introduced. Such arrangement forms an access port into the bodycavity through which surgical end effectors may be inserted. The innerdiameter of the trocar's cannula necessarily limits the size of the endeffector and drive-supporting shaft of the surgical instrument that maybe inserted through the trocar.

Regardless of the specific type of surgical procedure being performed,once the surgical end effector has been inserted into the patientthrough the trocar cannula, it is often necessary to move the surgicalend effector relative to the shaft assembly that is positioned withinthe trocar cannula in order to properly position the surgical endeffector relative to the tissue or organ to be treated. This movement orpositioning of the surgical end effector relative to the portion of theshaft that remains within the trocar cannula is often referred to as“articulation” of the surgical end effector. A variety of articulationjoints have been developed to attach a surgical end effector to anassociated shaft in order to facilitate such articulation of thesurgical end effector. As one might expect, in many surgical procedures,it is desirable to employ a surgical end effector that has as large arange of articulation as possible.

Due to the size constraints imposed by the size of the trocar cannula,the articulation joint components must be sized so as to be freelyinsertable through the trocar cannula. These size constraints also limitthe size and composition of various drive members and components thatoperably interface with the motors and/or other control systems that aresupported in a housing that may be handheld or comprise a portion of alarger automated system. In many instances, these drive members mustoperably pass through the articulation joint to be operably coupled toor operably interface with the surgical end effector. For example, onesuch drive member is commonly employed to apply articulation controlmotions to the surgical end effector. During use, the articulation drivemember may be unactuated to position the surgical end effector in anunarticulated position to facilitate insertion of the surgical endeffector through the trocar and then be actuated to articulate thesurgical end effector to a desired position once the surgical endeffector has entered the patient.

Thus, the aforementioned size constraints form many challenges todeveloping an articulation system that can effectuate a desired range ofarticulation, yet accommodate a variety of different drive systems thatare necessary to operate various features of the surgical end effector.Further, once the surgical end effector has been positioned in a desiredarticulated position, the articulation system and articulation jointmust be able to retain the surgical end effector in that locked positionduring the actuation of the end effector and completion of the surgicalprocedure. Such articulation joint arrangements must also be able towithstand external forces that are experienced by the end effectorduring use.

Various surgical instruments employ a variety of different drive shaftarrangements that serve to transmit drive motions from a correspondingsource of drive motions that is supported in a handle of the surgicalinstrument or other portion of an automated or robotically controlledsystem. These drive shaft arrangements must be able to accommodatesignificant articulated orientations of the end effector whileeffectively transmitting such drive motions across the articulationjoint of the surgical instrument. In addition, due to theabove-mentioned size constraints dictated by the sizes of trocarsthrough which the instrument shafts must be inserted, these drive shaftcomponents must occupy as little space as possible within the shaft. Toaccommodate such requirements, many drive shaft arrangements compriseseveral movable elements that are coupled together in series. The smallsizes (e.g., 4 mm diameter) and numbers of components lead to difficultand lengthy assembly procedures that add to the cost and complexity ofthe device.

As further described herein, a powered stapling device can include twoindependently rotatable drive members: a first rotary drive memberconfigured to effect closing of the jaws of the end effector and asecond rotary drive member configured to effect firing of a staplecartridge installed in the end effector. The first and second rotarydrive members are flexible and configured to extend through at least onearticulation joint. In such instances, the first and second rotary drivemembers can transmit rotary actuation motions through the articulationjoint(s) when in a non-flexed configuration and when in a flexedconfiguration. Exemplary rotary drive members are further describedherein.

The powered stapling assembly further comprises a first jaw, a secondjaw, a closure drive comprising the first rotary drive member extendingthrough the articulation joint, and a firing drive comprising the secondrotary drive member extending through the articulation joint. The secondrotary drive member can be rotatable independent of the first rotarydrive member. The closure drive can be activated by a closure trigger,for example, whereupon an actuation of the closure drive effects arotation of the first rotary drive member, which transmits a rotarymotion through the articulation joint to a closure screw. The closuredrive further comprises a closure wedge threadably coupled to theclosure screw, wherein the closure wedge is configured to engage thefirst jaw to move the first jaw from an open position to a closedposition upon rotation of the first rotary drive member.

The firing drive can be activated by a firing trigger, for example,which is separate from the closure trigger. The rotation of the secondrotary drive member is separate from the rotation of the first rotarydrive member, and a closure motion is separate and distinct from afiring motion. Activation of the firing drive effects a rotation of thesecond rotary drive member, which transmits a rotary motion through thearticulation joint to a firing screw. The firing drive further comprisesa firing member threadably coupled to the firing screw, wherein thefiring member is configured to camming engage the first jaw and thesecond jaw and to move a cutting member and/or a staple-firing sled uponrotation of the second rotary drive member.

In various instances, at least one component in the powered staplingdevice can be a 3D-printed component. 3D-printed components can beincorporated into an articulation system, a closure/grasping system,and/or a firing system, as further described herein. 3D printingtechnology can be utilized to improve component capabilities in certaininstances. For example, 3D printing can allow the printed component toexhibit metamaterial properties, such that the 3D-printed componentsexhibits greater structural strength and stiffness while allowingprecision in the forming of small detailed features and optimizing otherproperties of the component such as selective flexibility and/orlubrication, for example. Exemplary 3D-printed components for thepowered stapling device are further described herein and include theflexible rotatable drive member(s), e.g. serial 3D-printed universaljoints, the firing member or I-beam, and/or the staple cartridge and/orsub-components thereof. In one instance, the staple cartridge can be acomposite plastic-metal 3D-printed component. 3D printing of variouscomponents and considerations therefor are further described herein.

A method of stapling with such surgical stapling assemblies is alsocontemplated. The method can include obtaining the surgical staplingassembly and activating, by the closure trigger, the closure drive,wherein the closure wedge is configured to engage the first jaw to movethe first jaw from an open position to a closed position upon a rotationof the first rotary drive member. The method can further includesactivating, by the firing trigger, the firing drive, wherein the firingmember is configured to camming engage the first jaw and the second jawand to advance a cutting member and a staple-firing sled during a firingmotion upon a rotation of the second rotary drive member. Variousapplications of 3D-printed components in such assemblies are furtherdescribed herein.

FIGS. 26-29 illustrate one form of a universally movable joint 60200that may be fabricated by various additive manufacturing processcommonly falling under the umbrella term of “three dimensional (3D)”printing. As will become further evident as the present disclosureproceeds, the use of such processes to produce a universally movablejoint 60200 that may be employed to form various drive shaftarrangements disclosed herein may address many if not all of the sizeand assembly challenges discussed above.

Various forms of additive manufacturing systems are known formanufacturing components from sinterable building materials, forexample. FIG. 24 illustrates in general form, an additive manufacturingsystem 60100 that may implement a manufacturing process 60000 forforming a universally movable joint 60200, in accordance with at leastone aspect of the present disclosure. As used herein, the term “additivemanufacturing” may encompass, but is not limited to, “selective lasermelting (SLM),” “direct metal laser melting (DMLM),” “laser powder bedfusion (LPBF),” and various other known systems as well as those systemsdisclosed for example in U.S. Pat. No. 9,815,118, entitled FABRICATINGMULTI-PART ASSEMBLIES, the entire disclosure of which is hereinincorporated by reference.

By way of non-limiting example, the additive manufacturing system 60100comprises a printer 60120 that may include a fused filament fabricationsystem, a binder jetting system, a stereolithography system, a selectivelaser sintering system, or any other system that can be usefully adaptedor employed to form a universally movable joint 60200 described hereinunder computer control from or out of a build material 60130. In atleast one form, the build material 60130 may comprise sinterablematerials commonly employed with such printers. For example, inaccordance with various aspects of the present disclosure, the buildmaterial 60130 may comprise 316 stainless steel, 17-4 stainless steel,Ti-64 titanium, etc. As will be discussed in further detail below,various other forms of build materials (metal and non-metal) may also beemployed.

In one aspect, the additive manufacturing system 60100 may comprise acomputer system 60125 that is configured to generate a computer aideddesign (CAD) three dimensional file of the universally movable joint60200. The CAD file data may then be sliced into layers forming a twodimensional image of each layer. This file may then be loaded into afile preparation software package that assigns parameters, values, andphysical supports that allow the file to be interpreted by the printer60120. In a general form, the printer 60120 may comprise a build chamber60122 that includes a build plate or platform 60124 and a laser 60126.In accordance with one non-limiting aspect, the build chamber 60122 mayfurther include a material dispensing platform (not shown) and are-coater member (not shown) that is used to move new build material60130 over the build plate 60124. In at least one arrangement, the buildmaterial 60130 is commonly in powered form (“first state”) and the laser60126 fuses the powdered build material 60130 into a solid part (“secondstate”) by melting it locally using the focused laser beam. For example,the component portions of the universally movable joint 60200 may bebuilt up additively, layer by layer.

Support structures may be required in many additive manufacturingprocesses to dissipate heat away from the printed component and into thebuild plate as well as to support the component throughout themanufacturing process. Overhanging features of a printed componentgenerally have no underlying solid layer to support them at any point.Such overhanging features may therefore be more prone to deformationduring manufacturing caused by gravity, internal heat, and residualstresses. In such instances, to avoid this deformation, supportstructures may be employed to support those overhanging features duringthe additive manufacturing process. While such support structures areuseful for these reasons, they must be removed from the formed componentor part after the process is completed. This results in wasted materialand can lead to increased manufacturing costs.

In one non-limiting example, the additive manufacturing system 60100 mayinclude a conveyor 60140 for transporting a printed “green” universallymovable joint 60200G to a post-processing station 60150. As used in thiscontext, the term “green” may refer to a condition of the universallymovable joint 60200 wherein one or more component portions thereof lacksone or more of the following attributes: (i) final desired composition,(ii) final desired strength, (iii) final desired dimension(s), (iv)final desired shape, (v) final desired density, and/or (vi) finaldesired finish, for example. The conveyor 60140 may be any suitablemechanism or combination of devices suitable for physically transportingthe green universally movable joint 60200G. This may, for example,include a robotics and a machine vision system or the like on theprinter side for detaching the green universally movable joint 60200Gfrom the build plate 60124, as well as robotics and a machine visionsystem or the like on the post-processing side to accurately place thegreen universally movable joint 60200G within the post-processingstation 60150. In another aspect, the green universally movable joint60200G may be manually transported between the two correspondingstations.

The post-processing station 60150 may be any system or combination ofsystems useful for converting the green universally movable joint 60200Ginto the desired net final shape, net final dimension, net finaldensity, net final strength and/or net final finish, for example. Thepost-processing station 60150 may also or instead, for example, includea de-binding station such as a chemical de-binding station fordissolving binder materials in a solvent or the like, or more generally,any de-binding station configured to remove at least a portion of thebinder system from the various forms of build materials 60130. Thepost-processing station 60150 may, for example, also or instead includea thermal sintering station for applying a thermal sintering cycle at asintering temperature for the build material 60130, or the powderedmaterial in the build material 60130, such as a sintering furnaceconfigured to sinter the powdered material into a densified object. Thepost-processing station may also or instead comprise a heat treatingstation. The post processing station may also or instead comprise asystem for removing unformed build material and/or support materialusing a variety of different mediums including, but not limited to,liquids, solvents, air pressure, gravity, etc.

Further, a wide range of sintering techniques may be usefully employedby the post-processing station 60150. In one aspect, the greenuniversally movable joint 60200G may be consolidated in a furnace to ahigh theoretical density using vacuum sintering, for example. In anotheraspect, the furnace may use a combination of flowing gas (e.g., at belowatmosphere, slightly above atmosphere, or some other suitable pressure)and vacuum sintering. More generally, any sintering or other processsuitable for improving object density may be used, preferably where theprocess yields a near-theoretical density part with little or noporosity. Hot-isostatic pressing (“HIP”) may also or instead beemployed, e.g., by applying elevated temperatures and pressures as apost-sintering step to increase density of the final part. In anotheraspect, the universally movable green joint 60200G may be processedusing any of the foregoing, followed by a moderate overpressure (greaterthan the sintering pressure, but lower than HIP pressures). Moregenerally, any technique or combination of techniques suitable forremoving binder systems and driving a powdered material towardconsolidation and densification may be used by the post-processingstation 60150 to process a fabricated universally movable joint 60200 ascontemplated herein.

The post-processing station 60150 may also or instead comprise machiningoperations configured to remove support structure(s) (if any) and/ormachine the component portions of the green universally movable joint60200G that have been printed within “near net” dimensions to providethe joint components with final desired dimensions and shapes. Thepost-processing station 60150 may also or instead include a DirectedEnergy Deposition (DED) process which in one form may comprise a threedimensional (3D) printing method that employs a focused energy source,such as a plasma arc, laser or electron beam to melt a material which issimultaneously deposited by a nozzle. Such DED process may be used forexample to repair or add additional material to a green universallymovable joint 60200G or finished universally movable joint 60200. Thepost-processing station 60150 may also or instead comprise various gritblasting and/or polishing operations for attaining a desired finalsurface finish of the universally movable joint 60200.

FIG. 25 illustrates one non-limiting example of a manufacturing process60000 for forming a universally movable joint 60200. In one generalaspect, the manufacturing process 60000 comprises the action 60010 ofdeveloping a computer aided designed (CAD) file of the universallymovable joint 60200 in a format that is useable by the printer 60120.The manufacturing process 60000 further includes the action 60020 ofimplementing the computer designed file to cause the printer 60120 toform a green universally movable joint 60200G from build material 60130that is supplied to the build chamber 60122 of the printer 60120. In atleast one non-limiting form, the manufacturing process 60000 may furthercomprise the action 60030 of post-processing the green universallymovable joint 60200G to form a final universally movable joint 60200 asdescribed and contemplated herein. The action 60030 may include one ormore actions described herein designed to provide the green universallymovable joint 60200G and the components thereof with a final desiredcomposition, strength, shape, dimensions, density, and/or finish, forexample.

FIGS. 26-29 illustrate a completed or finished universally movable joint60200 that was formed using the additive manufacturing system 60100. Asshown in FIGS. 26-29, one form of the universally movable joint 60200comprises a cross-shaped joint spine 60300, a vertical U-joint 60400 anda horizontal U-joint 60500. In at least one embodiment, for example, thejoint spine 60300 defines a vertical axis VA-VA and a horizontal axisHA-HA that is transverse to the vertical axis VA-VA. In one arrangement,the horizontal axis HA-HA is orthogonal to the vertical axis VA-VA. Ascan be seen in FIGS. 27 and 29 for example, the joint spine 60300comprises a bottom axle segment 60310 that is axially aligned on thevertical axis VA-VA and includes a flared bottom end 60312. The flaredbottom end 60312 defines an arcuate bottom surface 60314. The jointspine 60300 further comprises a top axle segment 60320 that is axiallyaligned on the vertical axis VA-VA and includes a flared top end 60322that defines an arcuate top surface 60324. The joint spine 60300 furthercomprises a first or right horizontal axle segment 60330 that is axiallyaligned on the horizontal axis HA-HA and terminates in a first conicalend portion 60334. The joint spine 60300 also comprises a second or lefthorizontal axle segment 60340 that is axially aligned on the horizontalaxis HA-HA and terminates in a second conical end portion 60344.

Still referring to FIGS. 28 and 29, the vertical U-joint 60400 in atleast one form comprises a bottom “wishbone” or bottom joint ring 60410that is journaled on the bottom axle segment 60310 for rotationtherearound. The flared bottom end 60312 of the joint spine 60300permanently retains the bottom joint ring 60410 on the bottom axlesegment 60310. In one non-limiting example, the vertical U-joint 60400further comprises a top “wishbone” or top joint ring 60420 that isjournaled on the top axle segment 60320 for rotation therearound. Theflared top end 60322 of the joint spine 60300 permanently retains thetop joint ring 60420 on the top axle segment 60320. The vertical U-joint60400 further comprises a U-shaped vertical bridge 60430 that protrudesfrom the bottom joint ring 60410 and the top joint ring 60420 andextends therebetween. The U-shaped vertical bridge 60430 comprises anarcuate outer surface 60431 that serves to facilitate pivotal travel andmovement of the vertical U-joint 60400 with the tight confines of ahollow outer shaft portion of a surgical instrument and/or surgicaltrocar. The vertical U-joint 60400 comprises one integrally formedcomponent of the universally movable joint 60200 that is rotatable aboutthe vertical axis VA-VA of the joint spine 60300 and is permanentlyretained thereon by the flared bottom end 60312 and the flared top end60322 as well as the U-shaped vertical bridge 60430. Stated another way,the vertical U-joint 60400 cannot be detached from the joint spine 60300without damaging one or both of those components.

In accordance with another aspect of the present disclosure, thehorizontal U-joint 60500 in at least one form comprises a firsthorizontal “wishbone” or joint cap 60510 that is rotatably journaled onthe first horizontal axle segment 60330 and a second horizontal“wishbone” or joint cap 60520 that is rotatably journaled on the secondhorizontal axle segment 60340. The horizontal U-joint 60500 furthercomprises a U-shaped horizontal bridge 60530 (FIG. 26) that protrudesfrom the first horizontal joint cap 60510 and the second horizontaljoint cap 60520 and extends therebetween. The U-shaped horizontal bridge60530 comprises an arcuate (as opposed to a flat) outer surface 60531that serves to facilitate pivotal travel and movement of the horizontalU-joint 60500 with the tight confines of a hollow outer shaft portion ofa surgical instrument and or surgical trocar. The horizontal U-joint60500 comprises one integrally formed component of the universallymovable joint 60200 that is rotatable about the horizontal axis HA-HA ofthe joint spine 60300 and is permanently retained thereon by theU-shaped horizontal bridge 60530. See FIG. 26. Stated another way, thehorizontal U-joint 60500 cannot be detached from the joint spine 60300without damaging one or both of those components.

Turning to FIG. 29, in at least one non-limiting example, the bottomjoint ring 60410 comprises a bottom ring inner surface 60412 that isspaced from an outer surface 60316 of the bottom axle segment 60310 todefine a bottom joint space 60318 that extends between the bottom jointring 60410 and the bottom axle segment 60310 and opens to the bottom ofthe universally movable joint 60200 around the flared bottom end 60312.Similarly, the top joint ring 60420 comprises a top ring inner surface60422 that is spaced from an outer surface 60323 of the top axle segment60320 to define a top joint space 60326.

Still referring to FIG. 29, in accordance with another non-limitingexample, the first horizontal joint cap 60510 comprises a first hubportion 60512 that comprises a first hub inner surface 60514 and a firstcap portion 60516 that defines a first tapered end surface 60518. Thefirst hub inner surface 60514 is spaced from an outer surface 60332 ofthe first horizontal axle segment 60330 and the first tapered endsurface 60518 is spaced from the first conical end portion 60334 todefine a first horizontal joint space 60336 that extends between thefirst horizontal joint cap 60510 and the first horizontal axle segment60330 and the first conical end portion 60334. The first horizontaljoint space 60336 opens through a first hole 60519 in the first capportion 60516.

Similarly, the second horizontal joint cap 60520 comprises a second hubportion 60522 that comprises a second hub inner surface 60524 and asecond cap portion 60526 that defines a second tapered end surface60528. The second hub inner surface 60524 is spaced from an outersurface 60342 of the second horizontal axle segment 60340 and the secondtapered end surface 60528 is spaced from the second conical end portion60344 to define a second horizontal joint space 60346 that extendsbetween the second horizontal joint cap 60520 and the first horizontalaxle segment 60340 and the first conical end portion 60344. The secondhorizontal joint space 60346 opens through a second hole 60529 in thesecond cap portion 60526.

As can also be seen in FIG. 27, in a non-limiting example, the bottomjoint ring 60410 comprises a bottom joint ring outer surface 60414. Thetop joint ring 60420 comprises a top joint ring outer surface 60424. Thefirst horizontal joint cap 60510 comprises a first cap outer surface60517 and the second horizontal joint cap 60520 comprises a second outercap surface 60527. In the illustrated example, the bottom joint ringouter surface 60414 is spaced from the first cap outer surface 60517 todefine a first lower clearance space or “fillet” 60416 therebetween.Likewise, the bottom joint ring outer surface 60414 is spaced from thesecond cap outer surface 60527 to define a second lower clearance spaceor “fillet” 60418 therebetween. The top joint ring outer surface 60424is spaced from the first cap outer surface 60517 to define a first upperclearance space or “fillet” 60426 therebetween. Likewise, the top jointring outer surface 60424 is spaced from the second cap outer surface60527 to define a second upper clearance space or “fillet” 60428therebetween.

FIG. 30 illustrates a green universally movable joint 60200G that isstill supported on the build plate 60124. In this example, one form ofbuild material 60130 is employed. In a “first state”, the build material60130 comprises a powder material of the various types disclosed andcontemplated herein. Once transformed by the laser or othercomponent/system, for example, the build material 60130 comprises a“second” state. As shown in FIG. 30, various amounts of the buildmaterial 60130 in powder form, e.g., the “first state” (referred to inFIG. 30 as “60130U”) are located in the top joint space 60326, the firstupper clearance space 60426, the second upper clearance space 60428, thefirst horizontal joint space 60336, the second horizontal joint space60346, the first lower clearance space 60416, the second lower clearancespace 60418, and the bottom joint space 60318. Such amounts of unformedbuild material 60130U serve to support the vertical U-joint 60400 andthe horizontal U-joint 60500 on the joint spine 60300 during theprinting process and prevents those components from become fused ornon-movably formed together. After the green universally movable joint60200G has been formed, these amounts of unformed build material 60130Umust be removed from between the vertical U-joint 60400 and the jointspine 60300 and the horizontal U-joint 60500 and the joint spine 60300.In various instances, the amounts of unformed build material 60130U maybe removed under the influence of gravity and/or may be removed using aremoval medium (air, liquid, solvent, etc.) during post processing. Inone aspect, the first lower clearance or fillet 60416, the second lowerclearance or fillet 60418, the first upper clearance space or fillet60426, the second upper clearance space or fillet 60428 as well as thehole 60519 in the first horizontal joint cap 60510 and the second hole60529 in the second horizontal joint cap 60520 serve to facilitate easyremoval the amounts of build material 60130U from the green universallymovable joint 60200G. See FIGS. 30A-30C.

During the printing process or formation process, the joint spine 60300extends from the built plate 60124 and is formed vertically off thebuild plate 60124. The flared bottom end 60312 is formed off of thebuild plate 60124 and is attached thereto during formation. The flaredbottom end 60312 serves to support the joint spine 60300 during theprinting process. In one aspect, unformed build material 60130U aroundthe flared bottom end 60312, the bottom joint ring 40410, the firsthorizontal joint cap 60510 and the second horizontal joint cap 60520, aswell as the amounts of unformed build material 60130U in the spacesbetween the vertical U-joint 60400, the horizontal U-joint 60500, andthe joint spine 60300 may further help to maintain the verticalorientation of the joint spine 60300 (and the universally movable joint60200G) during the forming process without the use of support membersbetween the joint components and the build plate 60124. In sucharrangement, the flared bottom end 60312 facilitates thermal dissipationinto the build plate 60124. The bottom joint ring 60410 is formedwithout being attached to the build plate 60124. In accordance with atleast one aspect, universally movable joints 60200 having an overalldiameter of as small as approximately 4 mm may be formed in such amanner. Joints with larger diameters, for example, of approximately 10mm or more may require one or more support members to support the jointcomponents in a vertical orientation during the printing process. In anyevent, once the amounts of unformed (i.e., still in a first state orpowder form or unsolidified) build material 60130U are removed frombetween the joint components, the vertical U-joint 60400 is freelyrotatable on the joint spine 60300 about the vertical axis VA-VA and thehorizontal U-joint 60500 is freely rotatable about the joint spine 60300about the horizontal axis HA-HA. In addition, the vertical U-joint 60400and the horizontal U-joint 60500 cannot be removed from the joint spine60300 without damaging the universally movable joint 60200.

FIG. 31 illustrates a non-limiting example wherein support members 60600are formed between the flared bottom end 60312 and the build plate60124, and/or between the bottom joint ring 60410 and the build plate60124, and/or between the first horizontal joint cap 60510 and the buildplate 60124, and/or between the second horizontal joint cap 60520 andthe build plate 60124. The shapes, numbers, and compositions of suchsupport members can vary and are configured to be removed from theuniversally movable joint 60200G′ during post processing. In sucharrangement, various amounts 60130U of unformed building material may bereceived in the above-described spaces between the joint components andthereafter removed during post processing.

FIG. 32 illustrates a green universally movable joint 60200G formed froma build material 60130 of the types disclosed and contemplated herein.However, during this manufacturing process, a support material SM isintroduced during the process to separate components 60300, 60400, 60500during printing. Such support material SM may comprise a powderedsupport material that may be removed from the spaces between thecomponents under the influence of gravity, air pressure, liquid, etc.Other support materials SM that may be dissolved when contacted by asolvent medium are contemplated.

Other non-limiting systems and processes are contemplated wherein auniversally movable joint 60200 is formed from different build materialsand different support materials. For example, FIG. 33 illustrates auniversally movable joint 60200′ that is identical to universallymovable joint 60200 except for the differences noted below relating toits composition and formation. For example, the joint spine 60300′ maybe formed from a first build material FBM and the vertical U-joint60400′ and/or the horizontal U-joint member 60500′ may be fabricatedfrom a second build material SBM that is different from the first buildmaterial FBM. For example, the first build material FBM may comprise apolymer and the second build material may comprise a metal buildmaterial or vice versa. The first build material FBM and the secondbuild material SBM may be introduced in precise locations on the buildplate 60124 at predetermined times and locations to facilitate printingof the components from the desired materials. In other arrangements, oneof the components may be printed from the first build material FBM andthereafter the second build material SBM is introduced to form thesecond component(s). In one contemplated arrangement, for example, thejoint spine 60300′ may be printed from a material that is softer thanthe material used to form the vertical U-joint 60400′ and/or thehorizontal U-joint member 60500′. For example, in one arrangement, thejoint spine 60300′ is printed from a polymer material or softer materialsuch as brass or bronze, etc. and the vertical U-joint 60400′ andhorizontal U-joint 60500′ may be printed from a stainless steel,titanium, or other metal material, etc. Such combination of materialsmay result in reduced friction between these components. In still otherarrangements, the joint spine 60300′ may be fabricated from stainlesssteel, titanium, etc. and the vertical U-joint 60400′ and the horizontalU-joint 60500′ may be formed from softer materials such as brass,bronze, polymer, etc. Such arrangements may also employ a supportmaterial SM of the types contemplated herein to separate the componentparts and thereafter be removed from between those component partsduring post-processing operations.

FIGS. 34-36, illustrate another form of universally movable joint 60200″that is identical to universally movable joint 60200 except that thebottom end 60312″ is not flared and the top end 60322″ is not flared.The vertical U-joint 60400 is retained on the joint spine by theU-shaped vertical bridge 60430.

The various forms of universally movable joints 60200, 60200′, 60200″represent vast improvements over prior joint arrangements that have beenemployed in various drive shafts and/or articulation joints of surgicalinstruments. The universally movable joints 60200, 60200′, 60200″comprise a compact “integral” design that may avoid many of thechallenges and increased costs associated with assembling other multiplepart shaft/joint arrangements that may be employed in many surgicaldevices. The design of each of the universally movable joints 60200,60200′, 60200″ minimize/eliminate unsupported horizontal surfaces, whichcould otherwise lead to increased surface roughness and componentwarping. The universally movable joints 60200, 60200′, 60200″ may beprinted from metal build material and exhibit strength characteristicsthat are comparable to or exceed the strength characteristics ofmultiple part joints that are machined from similar metal material andassembled together with pins, screws, welding, etc. The present jointdesigns further minimize and, in many cases, eliminate the need fornumerous, elaborate support members during the printing process and canalso reduce post-processing operations and/or costs.

FIG. 37 illustrates a universally movable drive shaft segment 60700 thatcomprises multiple movable universally movable joints 60200A, 60200B,and 60200C that are printed in series in one single continuousmanufacturing system of the types contemplated herein. In onenon-limiting example, universally movable joint 60200A is substantiallyidentical to universally movable joint 60200 described herein exceptthat the U-shaped vertical bridge 60430A is formed with a U-shapedhorizontal bridge 60530B of the universally movable joint 60200B. AU-shaped vertical bridge 60430B of the universally movable joint 60200Bis formed with a U-shaped horizontal bridge 60530C of the universallymovable joint 60200C. In the illustrated non-limiting example, theuniversally movable joints 60200B and 600200C may otherwise be identicalin construction, fabrication, and operation to universally movable joint60200. The universally movable drive shaft segment 60700 may compriseadditional universally movable joints formed in series and is notlimited to three joints formed in series. The universally movable driveshaft segment 60700 may comprise two universally movable joints, threeor more than three universally movable joints serially formed togetherusing the methods and processes contemplated herein.

FIGS. 38-40 illustrate one form of an articulation joint assembly 61000that may be employed in the various surgical instruments disclosed andcontemplated herein as well as other surgical instrument arrangements,devices, and configurations. In one non-limiting example, thearticulation joint assembly 61000 comprises a proximal mounting member61100 that is configured to interface with a shaft assembly 61010 of asurgical instrument. For example, the proximal mounting member 61100 maybe welded or attached to a distal portion of the shaft assembly 61010 byany suitable means. See FIG. 39. In other arrangements, the proximalmounting member 61100 may comprise a portion of the shaft assembly61010. Also in a non-limiting example, the articulation joint assembly61000 further comprises a distal mounting member 61200 that isconfigured to interface with a surgical end effector 61020. The surgicalend effector 61020 may comprise any of the surgical end effectorsdisclosed or contemplated herein and may comprise, but is not limitedto, end effectors configured to manipulate tissue (graspers), endeffectors configured to cut and staple tissue (endocutters), clipappliers, and end effectors configured to cut and fasten tissue withultrasound, harmonic, radio frequency energy, etc. The distal mountingmember 61200 may be welded or attached to a proximal portion of thesurgical end effector 61020 by any suitable means. In otherarrangements, the distal mounting member 61200 may comprise a portion ofthe surgical end effector 61020.

In the non-limiting example illustrated in FIGS. 38-40, the proximalmounting member 61100 comprises a proximal shaft hole 61110 that isaxially aligned with a shaft axis SA-SA that is defined by the shaftassembly 61010. Similarly, the distal mounting member 61200 comprises adistal shaft hole 61210. The distal shaft hole 61210 may have a diameterthat is the same or similar to a diameter of the proximal shaft hole61110. The proximal shaft hole 61110 and the distal shaft hole 61210 aresized and configured to accommodate various flexible or otherwisemovable drive shafts, actuator components, conductors, cables, shaftsupport structures, etc. that extend from the shaft assembly 61010 tothe surgical end effector 61020. In various instances, such driveshafts, actuators, conductors etc. may be operably supported in one ormore flexible hollow conduits or support members that span between theproximal mounting member 61100 and the distal mounting member 61200 forexample. In other arrangements the drive shafts are supported in one ofthe shaft guides described below and contemplated herein. When thesurgical end effector 61020 is aligned on the shaft axis SA-SA with theshaft assembly 61010, the distal shaft hole 61210 is aligned with theproximal shaft hole 61110.

Still referring to FIGS. 38-40, in at least one non-limiting example,the articulation joint assembly 61000 further comprises a plurality ofarticulation link assemblies that are attached to and extend between theproximal mounting member 61100 and the distal mounting member 61200. Theillustrated non-limiting example comprises three articulation linkassemblies 61300A, 61300B, and 61300C. Other numbers of articulationlink assemblies are contemplated. Unless otherwise noted herein, thearticulation link assemblies 61300A, 61300B, 61300C are similar inconstruction and in at least one instance, may each be formed or printedusing the manufacturing systems of the types contemplated herein.Articulation link assembly 61300A comprises a proximal movable joint62200A and a distal movable joint 63200A that are very similar inconstruction and design to the universally movable joints 60200described herein. For example, a proximal movable joint 62200A comprisesa proximal joint spine 62300A, a proximal first joint member 62400A, anda proximal second joint member 62500A. Similarly, each distal movablejoint 63200A comprises a distal joint spine 63300A, a distal first jointmember 63400A, and a distal second joint member 63500A. In anillustrated non-limiting example, the vertical U-joint 62400A of theproximal first joint member 62400A and the vertical U-joint 63400A ofthe distal first joint member 63400A may be similar in design to thevertical U-joint 60400 described above, except that a link member 62600Aprotrudes from a proximal first bridge member 62430A of the proximalfirst joint member 62400A and a distal first bridge member 63430A of thedistal first joint member 63400A and extends therebetween. In oneinstance, the link member 62600A comprises a circular cross-sectionalshape. The circular cross-sectional shape better facilitates passage ofoperation shafts and control members in the area defined between thelink members 62600A, 62600B, 62600C, as will be further discussed below.The proximal first joint member 62400A is configured to pivot relativeto the proximal joint spine 62300A about a first proximal axis FPA-FPAand the distal first joint member 63400A is configured to pivot relativeto the distal joint spine 63300A about a first distal axis FDA-FDA.

As can be further seen in FIGS. 38-40, the proximal second joint member62500A may be similar in design to the horizontal U-joint 60500described above, except that a mounting feature 62700A protrudes from aproximal second bridge member 62530A of the proximal second joint member62500A. In one non-limiting example, the mounting feature 62700A isconfigured to be received in a corresponding proximal axial mountingslot 61120A provided in the proximal mounting member 61100. Tofacilitate easy assembly, the proximal mounting feature 62700A comprisesa hook portion 62702A that is configured to hook over a retaining lug61122A formed in the proximal axial mounting slot 61120A. In onearrangement, the hook portion 62702A is spaced from the proximal secondbridge member 62530A by a tapered opening 62704A and is configured tointerface with the retaining lug 61122A which is wedge-shaped tonon-movably wedgingly affix the proximal movable joint 62200A to theproximal mounting member 61100. In one aspect, the wedge-shapedinterface may be sufficient to non-movably couple the proximal movablejoint 62200A to the proximal mounting member 61100. In otherarrangements, in addition to the wedge-shaped interface, the mountingfeature 62700A in the alternative to or in addition to may be affixed tothe proximal mounting member 61100 by welding, adhesive or othersuitable mounting means. In one instance, the mounting features 62700Amay simply be retained in hooking engagement with the proximal mountingmember 61100 and the distal mounting member 61200 by a conduit or shaftguide that extends through the proximal shaft hole 61110 and the distalshaft hole 61210. In still other arrangements, the proximal mountingfeature 62700A may comprise a stem feature (not shown) configured to bemovably inserted into a corresponding axial slot (not shown) in theproximal mounting member 61100 to facilitate axial movement of theproximal movable joint 62200A relative to the proximal mounting member61100. In at least one non-limiting example, the distal movable joint63200A may be similarly constructed and coupled to the distal mountingmember 61200 and will not be repeated in detail herein. In variousinstances, when a shaft guide or hollow conduit extends between theproximal mounting member 61100 and the distal mounting member 61200, theconduit or shaft guide serves to prevent the proximal mounting features62700A from disengaging from the proximal mounting member 61100 and thedistal mounting features from disengaging from the distal mountingmember 61200.

Articulation link assemblies 61300B and 61300C are similar in design tothe articulation link assembly 61300A described in detail above. As canbe seen in FIGS. 38-40, the proximal movable joint 62200A of thearticulation link assembly 61300A is attached to the proximal mountingmember 61100 at a first proximal attachment location FPA defined by theaxial mounting slot 61120A. Likewise, the distal movable joint 63200A ofthe articulation assembly 61300A is formed with a distal mountingfeature (not shown) that is similar to the proximal mounting feature62700A for attachment to the distal mounting member 61200. The distalmovable joint 63200A is attached to the distal mounting member 61200 ata first distal attachment location FDA that is defined by a distal axialmounting slot 61220A in the distal mounting member 61200.

Still referring to FIGS. 38-40, the proximal movable joint 62200B of thearticulation link assembly 61300B is attached to the proximal mountingmember 61100 at a second proximal attachment location SPA defined by aproximal axial mounting slot 61120B and the proximal movable joint62200C of the articulation link assembly 61300C is attached to theproximal mounting member 61100 at a third proximal attachment locationTPA defined by a proximal axial mounting slot 61120C. In onenon-limiting example, the first proximal attachment location FPA, thesecond proximal attachment location SPA, and the third proximalattachment location TPA are equally spaced about the shaft axis SA-SA.Stated another way, angles A, B, and C are each approximately 120°.Similarly, the distal movable joint 63200B of the articulation linkassembly 61300B is attached to the distal mounting member 61200 at asecond distal attachment location SDA defined by a distal axial mountingslot 61220B and the distal movable joint 63200C of the articulation linkassembly 61300C is attached to the distal mounting member 61200 at athird distal attachment location TDA defined by a distal axial mountingslot 61220C. In one non-limiting example, the first distal attachmentlocation FDA, the second distal attachment location SDA, and the thirddistal attachment location TDA are equally spaced about the shaft axisSA-SA—angles D, E, and F are each approximately 120°. In onearrangement, when the surgical end effector 61020 is in an unarticulatedposition or, stated another way, axially aligned with the shaft assembly61010 on the shaft axis SA-SA, the first distal attachment location FDAis diametrically opposite to the first proximal attachment location FPA;the second distal attachment location SDA is diametrically opposite tothe second proximal attachment location SPA; and the third distalattachment location TDA is diametrically opposite to the third proximalattachment location TPA. In such arrangement, each of the link members62600A, 62600B, and 62600C may be slightly twisted around an opencentral tunnel area 62800 defined by the shaft holes to accommodateunencumbered passage and operation of various drive shafts and othercomponents from the shaft assembly 61010 to the surgical end effector61020. Stated another way, in at least one arrangement, the axis of eachof the link members 62600A, 62600B, are not parallel with each other andare not parallel with the shaft axis SA-SA. In one instance, the distalmounting member 61200 is rotatable relative to the proximal mountingmember 61100 during articulation to maintain the inner drive radius ofthe open central tunnel or open area 62800. In such arrangement, anaxial distance AD between the proximal mounting member 61100 and thedistal mounting member 61200 is constant throughout the articulationmotions/orientations of the articulation joint assembly 61000. See FIG.40.

To facilitate articulation of the end effector, at least two andpreferably four flexible articulation actuators (not shown) are attachedto the distal mounting member and movably extend through openings in theproximal mounting member to communicate with an articulation controlsystem supported in or by the housing or robotic system. For example,the flexible articulation actuators may comprise flexible cablesconfigured in the various manners contemplated herein and described infurther detail below. Other suitable articulation drive systems may beemployed.

FIG. 41 illustrates another form of an articulation joint assembly 64000that is somewhat similar in design and use to the articulation jointassembly 61000 described above. In one non-limiting example, thearticulation joint assembly 64000 comprises a proximal mounting member64100 that is configured to interface with a shaft assembly 64010 of asurgical instrument. For example, the proximal mounting member 64100 maybe welded or attached to a distal portion of the shaft assembly 64010 byany suitable means. In other arrangements, the proximal mounting member64100 may comprise a portion of the shaft assembly 64010. Also in anon-limiting example, the articulation joint assembly 64000 furthercomprises a distal mounting member 64200 that is configured to interfacewith a surgical end effector 64020. The surgical end effector 64020 maycomprise any of the surgical end effectors disclosed or contemplatedherein and may comprise, but is not limited to, end effectors configuredto manipulate tissue (graspers), end effectors configured to cut andstaple tissue (endocutters), clip appliers, and end effectors configuredto cut and fasten tissue with ultrasound, harmonic, radio frequencyenergy, etc. The distal mounting member 64200 may be welded or attachedto a proximal portion of the surgical end effector 64020 by any suitablemeans. In other arrangements, the distal mounting member 64200 maycomprise a portion of the surgical end effector 64020.

In the non-limiting example illustrated in FIG. 41, the proximalmounting member 64100 comprises a proximal shaft hole 64110 that isaxially aligned with a shaft axis SA-SA defined by the shaft assembly64010. Similarly, the distal mounting member 64200 comprises a distalshaft hole 64210. The distal shaft hole 64210 may have a diameter thatis the same or similar to a diameter of the proximal shaft hole 64110.The proximal shaft hole 64110 and the distal shaft hole 64210 are sizedand configured to accommodate various flexible or otherwise movabledrive shafts, actuator components, conductors, cables, shaft supportstructures, etc. that extend from the shaft assembly 64010 to thesurgical end effector 64020. When the surgical end effector 64020 isaligned on the shaft axis SA-SA with the shaft assembly 64010, thedistal shaft hole 64210 is aligned with the proximal shaft hole 64110.

Still referring to FIG. 41, in at least one non-limiting example, thearticulation joint assembly 64000 further comprises a plurality ofarticulation link assemblies that extend between the proximal mountingmember 64100 and the distal mounting member 64200 and are attachedthereto. The illustrated non-limiting example comprises threearticulation link assemblies 64300A, 64300B, and 64300C that, in atleast one instance, may each be formed or printed using themanufacturing systems of the types contemplated herein. Other numbers ofarticulation link assemblies are contemplated. For example, anarticulation joint assembly that only comprises two articulation linkassemblies will work, but such articulation joint assembly may onlyfacilitate articulation through a single plane. Unless otherwise notedherein, the articulation link assemblies 64300A, 64300B, 64300C aresimilar in construction. Articulation link assembly 64300A comprises aproximal movable joint 65200A and a distal movable joint 66200A that arevery similar in construction and design to the universally movablejoints 60200 described herein. For example, a proximal movable joint65200A comprises a proximal joint spine 65300A, a proximal first jointmember 65400A, and a proximal second joint member 65500A. Similarly,each distal movable joint 66200A comprises a distal joint spine 66300A,a distal first joint member 66400A, and a distal second joint member66500A. In an illustrated non-limiting example, the U-Joint 65400A ofthe proximal movable joint 65200A and the U-joint 65400B of the distalmovable joint 66200A may be similar in design to the U-joint 60400described above, except that a link member 65600A protrudes from aproximal first bridge member 65430A of the proximal first joint member65400A and a distal first bridge member 66420A of the distal first jointmember 66400A and extends therebetween. The proximal first joint member65400A is configured to pivot relative to the proximal joint spine65300A about a first proximal axis and the distal first joint member66400A is configured to pivot relative to the distal joint spine 66300about a first distal axis in the manners disclosed herein. In otherembodiments, the mounting feature 65700A may comprise a hook-typefeature disclosed herein.

As can be further seen in FIG. 41, the proximal second joint member65500A may be similar in design to the horizontal U-joint 60500described above, except that a mounting feature 65700A protrudes from aproximal second bridge member 65530A of the proximal second joint member65500A. In one non-limiting example, the mounting feature 65700A isconfigured to be received in a corresponding proximal axial mountinghole 64120A provided in the proximal mounting member 64100. Sucharrangement facilitates easy assembly and may, in at least onealternative arrangement, permit axial movement of the articulation link64300A relative to the proximal mounting member 64100.

Articulation link assemblies 64300B and 64300C are similar in design tothe articulation link assembly 64300A described in detail above. As canbe seen in FIG. 41, the proximal movable joint 65200A of thearticulation link assembly 64300A is attached to the proximal mountingmember 64100 at a first proximal attachment location FPA defined by theaxial mounting slot 64120A. Likewise, the distal movable joint 66200A ofthe articulation assembly 64300A is formed with a distal mountingfeature 66700A that is similar to the proximal mounting feature 62700Afor axially movable attachment to the distal mounting member 64200. Thedistal movable joint 65200A is attached to the distal mounting member64200 at a first distal attachment location FDA that is defined by adistal axial mounting slot 64220A in the distal mounting member 64200.In one instance, the link assemblies 64300A, 64300B, 64300C may becompressed between the proximal mounting member 64100 and the distalmounting member 64200 during assembly. In such arrangement, an axialdistance between the proximal mounting member 64100 and the distalmounting member 64200 is constant throughout the articulationmotions/orientations of the articulation joint assembly 64000. In otherinstances, the proximal mounting member 64100 and the distal mountingmember 64200 may be spaced from each other a desired distance so as topermit some limited axial movement of the link assemblies 64300A,64300B, 64300C.

Still referring to FIG. 41, the proximal movable joint 65200B of thearticulation link assembly 64300B is attached to the proximal mountingmember 64100 at a second proximal attachment location SPA defined by aproximal axial mounting slot 64120B and the proximal movable joint65200C of the articulation link assembly 64300C is attached to theproximal mounting member 64100 at a third proximal attachment locationTPA defined by a proximal axial mounting slot 64120C. In onenon-limiting example, the first proximal attachment location FPA, thesecond proximal attachment location SPA, and the third proximalattachment location TPA are equally spaced about the shaft axis SA-SA.Similarly, the distal movable joint 66200B of the articulation linkassembly 64300B is attached to the distal mounting member 64200 at asecond distal attachment location SDA defined by a distal axial mountingslot 64220B and the distal movable joint 66200C of the articulation linkassembly 64300C is attached to the distal mounting member 64200 at athird distal attachment location TDA defined by a distal axial mountingslot 64220C. In one non-limiting example, the first distal attachmentlocation FDA, the second distal attachment location SDA, and the thirddistal attachment location TDA are equally spaced about the shaft axisSA-SA. In one arrangement, when the surgical end effector 64020 is in anunarticulated position or, stated another way, axially aligned with theshaft assembly 64010 on the shaft axis SA-SA, the first distalattachment location FDA is diametrically opposite to the first proximalattachment location FPA; the second distal attachment location SDA isdiametrically opposite to the second proximal attachment location SPA;and the third distal attachment location TDA is diametrically oppositeto the third proximal attachment location TPA. In such arrangement, eachof the link members 65600A, 65600B, and 65600C are slightly twistedaround an open central tunnel or open area 65800 defined by the shaftholes 64110, 64210 to accommodate unencumbered passage and operation ofvarious drive shafts and other components from the shaft assembly 64010to the surgical end effector 64020. Stated another way, in at least onearrangement, the axis of each of the link members 62600A, 62600B, arenot parallel with each other and are not parallel with the shaft axisSA-SA. In one instance, the distal mounting 64200 is rotatable relativeto the proximal mounting member 64100 during articulation to maintainthe inner drive radius of the open central tunnel or open area 65800.

To facilitate articulation of the end effector, at least two andpreferably four flexible articulation actuators (not shown) are attachedto the distal mounting member 64200 and movably extend through openingsin the proximal mounting member 64100 to communicate with anarticulation control system supported in or by the housing or roboticsystem. For example, the flexible articulation actuators may compriseflexible cables configured in the various manners contemplated hereinand described in further detail below. Other suitable articulation drivesystems may also be employed.

FIGS. 42 and 43 depict another non-limiting arrangement for coupling oneof the movable joint members disclosed herein to a mounting member 67100that may be attached to a portion of a shaft assembly or a portion of asurgical end effector in the various manners disclosed herein. In theillustrated example, the mounting member 67100 comprises an axial slot67120 that corresponds to each universally movable joint 60200″ that isto be coupled thereto. Each slot 67120 has a stop 67122 formed thereinto limit axial travel in one direction. The universally movable joint60200″ is substantially identical to the universally movable joints60200, 60200′ described herein except that a mounting stem or mountingfeature 67700 protrudes from the U-shaped vertical bridge 60430 of thevertical U-joint 60400. A stop block 67702 is formed on the end of themounting stem 67700 to engage the stop 67122 formed in the axial slot67120 to limit the axial travel of the universally movable joint 60200″in the direction PD.

The mounting member 67100 includes a shaft hole 67110 configured topermit various drive shafts and/or other instrument components to passtherethrough. In one non-limiting arrangement, each slot 67120 opensinto the shaft hole 67110. FIG. 43 illustrates a portion of a shaft orconduit 67200 extending through the shaft hole 67110. In sucharrangement, the shaft or conduit 67200 retains the mounting member67700 and the stop block 67702 in the corresponding axial slot 67120.Depending on the axial length of the mounting stem or feature 67700, themounting stem 67700 and stop block 67702 may move axially in the axialslot 67120 which facilities axial movement of the universally movablejoint 60200″ relative to the mounting member 67100. In otherarrangements, the mounting stems 67700 and stop blocks 67702 may benon-movably retained within their corresponding axial slots 67120 bywelding, adhesive, or other suitable fastener means. Such arrangementsfacilitate easy assembly of the articulation joint components.

Returning now to the surgical stapling assembly 400 illustrated in FIGS.12-14, as was discussed above, the surgical stapling assembly 400, in atleast one form comprises an end effector 200 that is operably coupled toa shaft assembly 410 by an articulation joint 420. The end effector 200comprises an anvil jaw 203 that is pivotally coupled to a cartridge jaw201 and is moved between an open and closed position relative thereto bya closure drive that is configured to operably interface with theclosure drive shaft segment 475. Additionally, the end effector 200further comprises a firing member 270 that operably interfaces with thefiring screw 261 such that as the firing screw 261 is rotated, thefiring member 270 is advanced distally or retracted proximally along thefiring screw 261. The firing screw 261 operably interfaces with thefiring drive shaft segment 476 which serves to transmit rotary drivemotions thereto from a firing drive. The firing drive may, for example,comprise any suitable source of rotary firing motions. For example, thefiring drive may comprise a firing drive motor operably supported in asurgical instrument housing or portion of a robotic system.

In one non-limiting arrangement for example, the closure drive comprisesa proximal closure drive shaft portion 68002 that extends through theouter shaft 411 of the shaft assembly 410 and operably interfaces with asource of rotary closure motions supported in or by the housing orrobotic system. The closure drive may further comprise an intermediateclosure drive shaft portion that bridges the articulation joint(s) and adistal closure drive shaft portion that is supported in the end effector200. In one arrangement, the proximal portion may comprise a rigid shaftsegment, a flexible shaft segment, or a combination of rigid andflexible segments, for example. In one non-limiting arrangement, theintermediate closure drive shaft portion may comprise one universallymovable joint (60200) or a series of movable joints or universallymovable drive shaft segment (60700) that spans the articulationjoint(s). The distal closure drive shaft portion may comprise a closuredrive shaft arrangement supported in the end effector to apply openingand closing motions to the anvil in the various manners disclosedherein.

Similarly, the firing drive may comprise a proximal firing shaft portionthat extends through the outer shaft 411 of the shaft assembly 410 andoperably interfaces with a source of rotary firing motions supported inor by the housing or robotic system. The firing drive may furthercomprise an intermediate firing drive shaft portion that bridges thearticulation joint(s) and a distal firing drive shaft portion that issupported in the end effector 200. In one arrangement, the proximalfiring drive shaft portion may comprise a rigid shaft segment, aflexible shaft segment, or a combination of rigid and flexible segments,for example. In one non-limiting arrangement, the intermediate firingdrive shaft portion may comprise one universally movable joint (60200)or a series of movable joints or universally movable drive shaft segment(60700) that spans the articulation joint(s). The distal firing driveshaft portion may comprise a firing drive shaft arrangement supported inthe end effector to apply drive motions to the firing member 270 in thevarious manners disclosed herein.

FIG. 44 illustrates a proximal closure drive shaft portion 68002, anintermediate closure drive shaft portion 68100, and a distal closuredrive shaft portion 68300 employed in the surgical stapling assembly 400described above. FIG. 44 also illustrates a proximal firing drive shaftportion 68004, an intermediate firing shaft portion 68500, and a distalfiring shaft portion 68600.

FIG. 45 illustrates one example of an intermediate closure drive shaftportion 68100 in accordance with at least one aspect of the presentdisclosure. As can be seen in FIG. 45, a proximal closure drive shaft68010 is attached to a closure coupler member 68110 for movementrelative thereto. In at least one non-limiting arrangement, the closurecoupler member 68110 is fabricated from a flexible material (polymer,rubber, etc.) that facilitates some torsional and axial flexure whileremaining sufficiently rigid to effective transmit the rotary closuremotions therethrough. For example, the closure coupler member 68110comprises an elongate body 68112 that includes a proximal end 68114 anda distal end 68116 and a central portion 68118 that extendstherebetween. The central portion 68118 has a central outer diameterthat is less than an outer diameter of each of the proximal end 68114and the distal end 68116 to facilitate axial flexing (arrow F).

The proximal closure drive shaft 68010 may comprise a rigid shaftsegment, a flexible shaft segment (e.g., torsion cable, etc.) or acombination of rigid and flexible segments, for example. The proximalclosure drive shaft 68010 may operably interface with a source of rotaryclosure motions (e.g., a motor, etc.) that is operably supported by orin a housing or portion of a robotic system, for example. In theillustrated arrangement, the proximal closure drive shaft 68010comprises a bulbous distal end 68012 that is received in a proximalsocket 68120 in the proximal end 68114 of the closure coupler member68110. The bulbous distal end 68012 of the proximal closure drive shaft68010 is pivotally coupled to the proximal end 68114 of the closurecoupler member 68110 by a proximal closure pin 68130 that is received inan X-shaped passage 68014 in the bulbous distal end 68012 of theproximal closure drive shaft 68010. It will be appreciated that theX-shaped passage 68014 facilitates some pivotal travel between theproximal closure drive shaft 68010 and the closure coupler member 68110.

The closure coupler member 68110 is operably coupled to a distal closuredrive shaft 68300 which comprises the closure drive shaft segment 475depicted in FIG. 13 and includes a closure coupler shaft 68310 thatoperably interfaces with the closure screw 251 as will be discussed infurther detail below. In at least one arrangement, the closure couplershaft 68310 comprises a bulbous proximal end 68312 that is received in adistal socket 68122 of the closure coupler member 68110. The bulbousproximal end 68312 of the closure coupler shaft 68310 is pivotallycoupled to the distal end 68116 of the closure coupler member 68110 by adistal closure pin 68132 that is received in an X-shaped passage 68314in the bulbous proximal end 68312 of the closure coupler shaft 68310. Itwill be appreciated that the X-shaped passage 68314 facilitates somepivotal travel between the closure coupler shaft 68310 and the closurecoupler member 68110.

As can be seen in FIG. 45, the intermediate closure drive shaft portion68100 is housed within the articulation component support structure 440.In at least one arrangement, the articulation component supportstructure 440 is fabricated from a flexible material such as polymer,rubber, etc. and has an accordion-like shape to facilitate axial andbending flexure.

FIG. 46 illustrates one example of an intermediate firing drive shaftportion 68500 in accordance with at least one aspect of the presentdisclosure. As can be seen in FIG. 46, a proximal firing drive shaft68020 is attached to a firing coupler member 68510 for movement relativethereto. In at least one non-limiting arrangement, the firing couplermember 68510 is fabricated from a flexible material (polymer, rubber,etc.) that facilitates some torsional flexure, bending flexure, and/oraxial flexure while remaining sufficiently rigid to effective transmitthe rotary closure motions therethrough. For example, the firing couplermember 68510 comprises an elongate body 68512 that includes a proximalend 68514 and a distal end 68516 and a central portion 68518 thatextends therebetween. The central portion 68518 has a central outerdiameter that is less than an outer diameter of each of the proximal end68514 and the distal end 68516 to facilitate axial flexing (arrow F).

The proximal firing drive shaft 68020 may comprise a rigid shaftsegment, a flexible shaft segment (e.g., torsion cable, etc.) or acombination of rigid and flexible segments, for example. The proximalfiring drive shaft 68020 may operably interface with a source of rotaryfiring motions (e.g., a motor, etc.) that is operably supported by or ina housing or portion of a robotic system, for example. In theillustrated arrangement, the proximal firing drive shaft 68020 comprisesa bulbous distal end 68022 that is received in a proximal socket 68520in the proximal end 68514 of the firing coupler member 68510. Thebulbous distal end 68022 of the proximal firing drive shaft 68020 ispivotally coupled to the proximal end 68514 of the firing coupler member68510 by a proximal firing pin 68630 that is received in an X-shapedpassage 68024 in the bulbous distal end 68022 of the proximal firingdrive shaft 68020. It will be appreciated that the X-shaped passage68024 facilitates some pivotal travel between the proximal firing driveshaft 68020 and the firing coupler member 68510.

The firing coupler member 68510 is operably coupled to a distal firingdrive shaft portion 68600 which comprises the firing drive shaft segment476 depicted in FIG. 13 and includes a firing coupler shaft 68610 thatoperably interfaces with the firing screw 261 as will be discussed infurther detail below. In at least one arrangement, the firing couplershaft 68610 comprises a bulbous proximal end 68612 that is received in adistal socket 68522 of the firing coupler member 68510. The bulbousproximal end 68612 of the firing coupler shaft 68610 is pivotallycoupled to the distal end 68516 of the firing coupler member 68510 by adistal firing pin 68532 that is received in an X-shaped passage 68614 inthe bulbous proximal end 68612 of the firing coupler shaft 68610. As canbe seen in FIG. 46, the intermediate firing drive shaft portion 68500 ishoused within the articulation component support structure 440. It willbe appreciated that the X-shaped passage 68614 facilitates some pivotaltravel between the firing coupler shaft 68610 and the firing couplermember 68510.

FIG. 47 comprises a longitudinally extending cross-sectional view of aproximal end portion of the end effector 200 illustrating the distalclosure drive shaft portion 68300 and the distal firing drive shaftportion 68600. In the illustrated arrangement, the distal closure driveshaft portion 68300 comprises the closure screw 251 that is rotatablysupported the cartridge channel 210 by a channel mounting fixture 68700that is mounted within a proximal end of the cartridge channel 210. Thechannel mounting fixture 68700 facilitates rotation of the closure screw251 while preventing axial movement thereof. The closure screw 251comprises a series of closure drive threads that threadably interfacewith a threaded passage in the closure wedge 255. Rotation of theclosure screw 251 in a first rotary direction will cause the closurewedge 255 to axially move in a first axial direction and rotation of theclosure screw 251 in a second rotary direction opposite to the firstrotary direction will cause the closure wedge 255 to axially move in asecond axial direction. For example, rotation of the closure screw 251in a first rotary direction may cause the closure wedge 255 to axiallymove in a distal direction DD to apply a closure motion to the anvil203. Rotation of the closure screw 251 in a second rotary direction maycause the closure wedge 255 to axially move in a proximal direction toapply an opening motion to the anvil 203.

Still referring to FIG. 47, the closure screw 251 defines a distalclosure shaft axis DC-DC and includes a proximal mounting flange 68712and a closure coupler stem 68710 that protrudes proximally from theproximal mounting flange 68712 and is axially aligned on the distalclosure shaft axis DC-DC. The closure coupler stem 68710 has anon-circular cross-sectional shape and is adapted to be movably andnon-rotationally received in a coupler socket 68316 in a distal end ofthe closure coupler shaft 68310. In one non-limiting arrangement, as canbe seen in FIG. 48, closure coupler stem 68710 has a squarecross-sectional shape. Other arrangements may, for example, have ahexagonal cross-sectional shape. Coupler socket 68316 has a similarsquare shape and is configured to facilitate axial movement of theclosure coupler shaft 68310 relative to the closure screw 251 whiletransmitting rotary closure motions (torque) thereto. Such slidablecoupling arrangement may also avoid binding and stackup between thecoupled drive portions. The proximal mounting flange 68712, as well asthe coupler socket 68316, is freely rotatable in an opening 68714 in thesecond shaft joint component 450. A socket flange 68318 is provided on adistal end of the coupler socket 68316 which serves to limit theproximal travel of the coupler socket 68316 when the socket flange 68318contacts an end of the opening 68714. The closure coupler stem 68710 issized relative to the coupler socket 68316 such that when the couplersocket 68316 has reached the limit of its proximal travel, the closurecoupler stem 68710 remains in operable engagement with the couplersocket 68316 to prevent the closure screw 251 from becoming disconnectedfrom the closure coupler shaft 68310.

In the illustrated arrangement, the distal firing drive shaft portion68600 comprises the firing screw 261 screw that is rotatably supportedthe cartridge channel 210 by the channel mounting fixture 68700. Thechannel mounting fixture 68700 facilitates rotation of the firing screw261 while preventing axial movement thereof. The firing screw 261comprises a series of closure drive threads that threadably interfacewith a threaded passage in a threaded drive nut that is configured tooperably interface with the firing member 270 or a threaded passage inthe firing member 270 itself. Rotation of the firing screw 261 in afirst rotary direction will cause the firing member 270 to axially movein a first axial direction and rotation of the firing screw 261 in asecond rotary direction opposite to the first rotary direction willcause the firing member 270 to axially move in a second axial direction.For example, rotation of the firing screw 261 in a first rotarydirection may cause the firing member 270 to axially move in a distaldirection DD and rotation of the firing screw 261 in a second rotarydirection may cause the firing member 270 to axially move in a proximaldirection PD.

Still referring to FIG. 47, the firing screw 261 defines a distal firingshaft axis DF-DF and includes a proximal mounting flange 68722 and afiring coupler stem 68720 that protrudes proximally from the proximalmounting flange 68722 and is axially aligned on the distal firing shaftaxis DF-DF. The firing coupler stem 68720 has a non-circularcross-sectional shape and is adapted to be movably and non-rotationallyreceived in a coupler socket 68616 in a distal end of the firing couplershaft 68610. In one non-limiting arrangement, the firing coupler stem68720 has a square cross-sectional shape. Other arrangements may, forexample, have a hexagonal cross-sectional shape. Coupler socket 68616has a similar square shape and is configured to facilitate axialmovement of the firing coupler shaft 68610 relative to the firing screw261 while transmitting rotary (torque) firing motions thereto. Suchslidable coupling arrangement may also avoid binding and stackup betweenthe coupled drive portions.

The proximal mounting flange 68722 as well as the coupler socket 68616,are freely rotatable in an opening 68724 defined in the cartridgechannel 210 and the channel mounting fixture 68700. A socket flange68618 is provided on a distal end of the coupler socket 68616 whichserves to limit the proximal travel of the coupler socket 68616 when thesocket flange 68618 contacts an end of the opening 68724. The firingcoupler stem 68720 is sized relative to the coupler socket 68616 suchthat when the coupler socket 68616 has reached the limit of its proximaltravel, the firing coupler stem 68720 remains in operable engagementwith the coupler socket 68616 to prevent the firing screw 261 frombecoming disconnected from the firing coupler shaft 68610.

FIG. 49 illustrates intermediate closure drive shaft portion 69100 andan intermediate firing drive shaft portion 69500 employed in thesurgical stapling assembly 500 described above. The intermediate closuredrive shaft portion 69100 is configured to be operably attached to adistal closure drive shaft portion 68300′ which may comprise the closuredrive shaft segment 575 depicted in FIG. 16 and is substantially similarto the distal closure drive shaft portion 68300 described above. In thisembodiment, the intermediate closure drive shaft portion 69100 includesclosure coupler member 69110 that comprises a solid cylindrical bodythat is coupled to the proximal closure drive shaft portion 68002 andthe distal closure drive shaft portion 68300′ in the manners describedabove. In at least one non-limiting arrangement, the closure couplermember 69110 is fabricated from a flexible material (polymer, rubber,etc.) that facilitates some torsional and axial flexure while remainingsufficiently rigid to effective transmit the rotary closure motionstherethrough. Similarly, the intermediate firing drive shaft portion69500 is configured to be operably attached to a distal firing driveshaft portion 68600′ which comprises the firing drive shaft 576 depictedin FIG. 16 and is substantially similar to the distal firing drive shaftportion 68600 described above. In this embodiment, the intermediatefiring drive shaft portion 69500 includes firing coupler member 69510that comprises a solid cylindrical body that is coupled to the proximalfiring drive shaft portion 68004 in the manners described above. In atleast one non-limiting arrangement, the firing coupler member 69510 isfabricated from a flexible material (polymer, rubber, etc.) thatfacilitates some torsional and axial flexure while remainingsufficiently rigid to effective transmit the rotary closure motionstherethrough.

The closure and drive shaft arrangements depicted in FIGS. 44-49comprise dual rotary drive systems wherein the first (distal) portionsare prevent from moving axially and the second portions (intermediate)portion is slidably coupled thereto. Each rotary drive comprises threeportions: a proximal portion located in the shaft assembly, a distalportion located in the end effector, and an intermediate portion thatbridges the articulation joint(s). The intermediate portion couldcomprise one or more universally movable joints or a torsion cablecoupling. The distal portion is fixed longitudinally to the end effectorand the proximal portion is fixed to a retainer in the shaft to preventeither of those portions from moving longitudinally or axially, forexample. The intermediate portion may be slidably coupled to either oneor both of the proximal and distal portions. The sliding coupling couldbe coupled to either or both ends of the distal portion and proximalportion or it may comprise a separate sliding aspect. These arrangementsallow the intermediate portion to become effectively longer or shorteras the articulation joint(s) go through the range of motion. The slidingcoupling of the intermediate portion to the distal portion and/or theproximal portion could be fixed within a chamber that allows the distalend/or proximal portion to slide but limits the maximum slidingdistance. This prevents the drive from becoming separated if thearticulation joint becomes hyperextended. The sliding couple is a squareor hexagonal geometry that facilitates torque transmission but allowsfor allows for longitudinal sliding of the coupled drives. The dualintermediate portions are also supported by the articulation jointsupport structures that bridge the articulation joint. The couplingstructures of the articulation joints allow for fixed-floating,fixed-fixed (but bendable), fixed-sliding, and/or sliding-slidingcoupling of components.

FIG. 50 illustrates the end effector 200 and articulation region 110described above (FIGS. 1-6) in cross-section. As described above, theflexible drive segments 175, 176 each consist of universally movablejoints arranged or formed “end-to-end”. For example, the drive segments175, 176 may each comprise a plurality of universally movable joints60200 arranged end-to-end or the drive segments 175, 176 may comprise auniversally movable drive shaft segment 60700 that was manufacturedutilizing the additive manufacturing systems and processes described andcontemplated herein. In one non-limiting arrangement for example, theclosure drive 250 comprises a proximal closure drive shaft portion 69200that extends through the outer shaft 411 of the shaft assembly 410 andoperably interfaces with a source of rotary closure motions supported inor by the housing or robotic system (not shown). The proximal closuredrive shaft portion 69200 may comprise, for example, a torsion cable69202, a laser cut flexible shaft or other flexible rotary drive member,a rigid rotary drive member or a combination of a rigid rotary drivemember(s) and a flexible rotary drive member(s). As can be seen in FIG.50, the proximal closure drive shaft portion 69200 is coupled to anintermediate closure drive shaft portion 69300 that bridges both of thearticulation joints in the articulation joint region 110 that comprisesthe flexible drive shaft segment 175. The flexible drive shaft segment175 is coupled to a distal closure drive shaft portion 69400 thatcomprises a closure drive shaft arrangement that is supported in the endeffector to apply opening and closing motions to the anvil in thevarious manners disclosed herein.

Still referring to FIG. 50, in one non-limiting form, the distal closuredrive shaft portion 69400 comprises a closure coupler shaft 69410 thatoperably interfaces with the closure screw 251 in the manner describedherein. In at least one arrangement, the closure coupler shaft 69410 isintegrally formed with the flexible drive shaft segment such that theclosure coupler shaft 69410 is printed with the flexible drive shaftsegment 175 utilizing the additive manufacturing systems and processesdescribed and contemplated herein. In other arrangements, the closurecoupler shaft 69410 is otherwise attached to a distal-most universallymovable joint member 60200D in the flexible drive shaft segment 175 bywelding, adhesive, threads, etc. As discussed above, the closure screw251 includes a proximal mounting flange 68712 and a closure coupler stem68710 that protrudes proximally from the proximal mounting flange 68712.The closure coupler stem 68710 has a non-circular cross-sectional shapeand is adapted to be movably and non-rotationally received in a couplersocket 69416 in a distal end of the closure coupler shaft 69410. Theclosure coupler stem 68710 has a square cross-sectional shape. Otherarrangements may, for example, have a hexagonal cross-sectional shape.Coupler socket 68316 has a similar square shape and is configured tofacilitate axial movement of the closure coupler shaft 69410 relative tothe closure screw 251 while transmitting rotary closure motions (torque)thereto. Such slidable coupling arrangement may also avoid binding andstackup between the coupled drive portions. The proximal mounting flange68712, as well as the coupler socket 69416, is freely rotatable in anopening 68714 in the second shaft joint component 450.

In one aspect, the firing drive comprises a proximal firing drive shaftportion 69500 that extends through the outer shaft 411 of the shaftassembly 410 and operably interfaces with a source of rotary firingmotions that is supported in or by the housing or robotic system. Theproximal firing drive shaft portion 69500 may comprise, for example,another torsion cable 69502, laser-cut flexible shaft or anotherflexible rotary drive member, another rigid rotary drive member or acombination of another rigid rotary drive member and another flexiblerotary drive member. As can be seen in FIG. 50, the proximal firingdrive shaft portion 69500 is coupled to an intermediate firing driveshaft portion 69600 that bridges both of the articulation joints in thearticulation joint region 110 that comprises the flexible drive shaftsegment 176. The flexible drive shaft segment 176 is coupled to a distalfiring drive shaft portion 69700 that comprises a firing drive shaftarrangement supported in the end effector to apply firing drive motionsto the firing member 270 in the various manners disclosed herein.

Still referring to FIG. 50, in one non-limiting form, the distal firingdrive shaft portion 69700 comprises the flexible drive shaft segment 176and includes a firing coupler shaft 69710 that operably interfaces withthe firing screw 261 as was described above. In at least onearrangement, the firing coupler shaft 69710 is integrally formed withthe flexible drive shaft segment 176 such that the firing coupler shaft69710 is printed with the flexible drive shaft segment 176 utilizing theadditive manufacturing systems and processes described and contemplatedherein. In other arrangements, the firing coupler shaft 69710 isotherwise attached to a distal-most universally movable joint member60200DF in the flexible drive shaft segment 176 by welding, adhesive,threads, etc.

In the illustrated arrangement, the distal firing drive shaft portion69700 comprises the firing screw 261 that is rotatably supported thecartridge channel 210 by the channel mounting fixture 68700. The channelmounting fixture 68700 facilitates rotation of the firing screw 261while preventing axial movement thereof. The firing screw 261 comprisesa series of closure drive threads that threadably interface with athreaded passage in a threaded drive nut configured to operablyinterface with the firing member 270 or a threaded passage in the firingmember 270 itself. Rotation of the firing screw 261 in a first rotarydirection will cause the firing member 270 to axially move in a firstaxial direction and rotation of the firing screw 261 in a second rotarydirection opposite to the first rotary direction will cause the firingmember 270 to axially move in a second axial direction.

Still referring to FIG. 50, the firing screw 261 includes a firingcoupler stem 68720 that protrudes proximally. The firing coupler stem68720 has a non-circular cross-sectional shape and is adapted to bemovably and non-rotationally received in a coupler socket 69716 in adistal end of the firing coupler shaft 69710. In one non-limitingarrangement, the firing coupler stem 68720 has a square cross-sectionalshape. Other arrangements may, for example, have a hexagonalcross-sectional shape. Coupler socket 69716 has a similar square shapeand is configured to facilitate axial movement of the firing couplershaft 69710 relative to the firing screw 261 while transmitting rotary(torque) firing motions thereto. Such slidable coupling arrangement mayalso avoid binding and stackup between the coupled drive portions. Thus,rotation of the proximal closure shaft portion 69200 in a first rotarydirection will drive the closure wedge 255 distally to move the anviljaw 203 to pivot to the closed position shown in FIG. 50. Rotation ofthe proximal closure shaft portion 69200 in an opposite rotary directionwill drive the closure wedge 255 proximally to pivot the anvil jaw 203into an open position. After the anvil jaw 203 has been moved to theclosed position to clamp target tissue between the anvil jaw 203 and thestaple cartridge 220, rotation of the proximal firing shaft portion69500 in a first direction will cause the firing member 270 to movedistally within the staple cartridge 220 to drive the staples therefromand cut through the clamped tissue in the manner described herein.Rotation of the proximal firing shaft portion 69500 in an oppositerotary direction will cause the firing member 270 to move proximallyback to a starting position in which the anvil jaw 203 may be moved tothe open position to release the cut and stapled tissue.

FIGS. 51-53 illustrate a portion of a surgical stapling instrument 10′that is substantially similar to the surgical stapling instrument 10described above, except for the differences described in detail below.In particular, instead of the flexible drive shaft segments 175, 176that are formed from universally movable joints, the surgical staplinginstrument employs a closure drive 250′ comprises flexible closure driveshaft 69210 that extends through the outer shaft 101 of the shaftassembly 100 and operably interfaces with a source of rotary closuremotions that is supported in or by the housing or robotic system (notshown). The flexible closure drive shaft 69210 may comprise, forexample, a torsion cable, a laser cut flexible shaft or other flexiblerotary drive member, a rigid rotary drive member or a combination of arigid rotary drive member(s) (portion(s) inside the outer shaft 101) anda flexible rotary drive member(s) (portion(s) that spans thearticulation region 110). As can be seen in FIG. 53, the flexibleclosure drive shaft 69210 is coupled to the closure screw 251 to applyrotary closure motions thereto to open and close the anvil jaw 203 inthe manners described herein.

As can be further seen in FIGS. 52 and 53, the firing drive 260′comprises a flexible firing drive shaft 69520 that extends through theouter shaft 101 of the shaft assembly 100 and operably interfaces with asource of rotary firing motions supported in or by the housing orrobotic system (not shown). The flexible firing drive shaft 69520 maycomprise, for example, a torsion cable, a laser cut flexible shaft orother flexible rotary drive member, a rigid rotary drive member or acombination of a rigid rotary drive member (portion inside the outershaft 101) and a flexible rotary drive member (portion that spans thearticulation region 110). As can be seen in FIG. 53, the flexible firingdrive shaft 69520 is coupled to the firing screw 261 to apply rotaryfiring motions thereto to move the firing member 270 through the endeffector 200 in the manners described herein. In this arrangement, theportions of the flexible closure drive shaft 69210 and the flexiblefiring drive shaft 69520 that span the articulation region 110 aresupported in a flexible shaft guide 69000.

FIGS. 54-62 illustrate one form of a shaft guide 69000 that may beemployed in connection with the shaft assembly 100. In the illustratedexample, the shaft guide 69000 comprises a shaft guide body 69010 thatis sized to space across the articulation region 110. The shaft guidebody 69010 comprises a shaft guide proximal end 69020 and a shaft guidedistal end 69030 and defines a shaft guide axis SGA that extends betweenthe shaft guide proximal end 69020 and the shaft guide distal end 69030.The shaft guide body 69010 further comprises a first passage 69022 thatextends through the shaft guide body 69010 from the shaft guide proximalend 69020 to the shaft guide distal end 69030. In the illustratedexample, the first passage 69022 opens through the shaft guide proximalend 69020 on a first side FRP, of a first reference plane FRP-FRP (FIG.55) and opens through the shaft guide distal end 69030 on a first sideSRP₁ of a second reference plane SRP (FIG. 56). In the illustratedarrangement, a central portion 69024 of the first passage 69022 at leastpartially passes through one or both of the first reference plane FRPand the second reference plane SRP.

Still referring to FIGS. 55 and 56, the shaft guide body 69010 furthercomprises a second passage that extends through the shaft guide body69010 from the shaft guide proximal end 69020 to the shaft guide distalend 69030. The second passage 69026 opens through the shaft guideproximal end 69020 on a second side FRP2 of the first reference planeFRP (FIG. 55) and opens through the shaft guide distal end 69030 on asecond side SRP2 of the second reference plane SRP (FIG. 56). In theillustrated arrangement, a central portion 69028 of the second passage69026 at least partially passes through one or both of the firstreference plane FRP and the second reference plane SRP. As can be seenin FIG. 55, a proximal end 69023 of the first passage 69022 is bisectedby the second reference plane SRP and a proximal end 69027 of the secondpassage 69026 is also bisected by the second reference plane SRP. As canbe seen in FIG. 56, a distal end 69025 of the first passage 69022 isbisected by the first reference plane FRP and a distal end 69029 of thesecond passage 69026 is bisected by eth first reference plane FRP.

In at least one arrangement, the shaft guide 69000 is fabricated from abendable elastic or ductile material (e.g., polypropylene, low densitypolyethylene, liquid crystal polymer (LCP), Nylon, etc.) thatfacilitates twisting flexure of the shaft guide 69000 when the endeffector 200 is articulated about at least one of the first articulationaxis AA1-AA1 and the second articulation axis AA2-AA2. The shaft guidebody 69010 comprises a central body portion 69012 that extends betweenthe shaft guide proximal end 69020 and the shaft guide distal end 69030.In at least one non-limiting example, the central body portion 69012comprises central bulbous portion 69014 which may further facilitatesuch flexure during articulation. Further, in at least one arrangement,the shaft guide body 69010 comprises a proximal necked down portion69016 that is located between the central bulbous portion 69014 and theshaft guide proximal end 69020 and which essentially coincides with thefirst articulation axis AA1-AA1. The proximal necked down portion 69016may be formed by a first pair of opposed proximal scallops 69017 thatcorrespond to the first articulation axis AA1-AA1. See FIG. 54. Theshaft guide body 69010 may further comprise a distal necked down portion69018 that is located between the central bulbous portion 69014 and theshaft guide distal end 69030 and which essentially coincides with thesecond articulation axis AA2-AA2. The distal necked down portion 69018may be formed by a second pair of opposed distal scallops 69019 thatcorrespond to the second articulation axis AA2-AA2. Such “necked-down”or “reduced diameter” segments further facilitate flexure of the shaftguide 69000 during articulation of the end effector 200.

As can be seen in FIG. 55, in at least one arrangement, the shaft guideproximal end 69020 comprises an oval or egg shape that is aligned on aproximal long axis PLA that is aligned with the second reference planeSRP. Likewise, as can be seen in FIG. 56, the shaft guide distal end69030 comprises an oval or egg shape that is aligned on a distal longaxis DLA-DLA that is aligned with the first reference plane FRP.

As can be seen in FIG. 53, the shaft guide 69000 spans the articulationregion 110 and the shaft guide distal end 69030 is supported in and/orcoupled to the distal shaft feature 140 and the shaft guide proximal end69020 is supported in and/or attached to the proximal shaft feature 120.In the illustrated arrangement, the flexible drive shaft segment 175 isreceived within the first passage 69022 and the flexible drive shaftsegment 176 is received within the second passage 69026. The shaft guideproximal end 69020 is coupled to a portion of the proximal shaft feature120 and the shaft guide distal end 69030 is coupled to the distal shaftfeature 140. The flexible drive shaft segment 175 operably extendsthrough the first passage 69022 and the flexible drive shaft segment 176extends through the second passage 69026. In the illustrated example,the proximal closure drive shaft portion 69200 extends through the outershaft 101 of the shaft assembly 100 and is located on one lateral sideof the shaft guide axis SGA to be coupled to the intermediate closuredrive shaft portion 69300 (flexible drive shaft segment 175) supportedin the first passage 69022 in the shaft guide 69000. Likewise, theproximal firing drive shaft portion 69500 extends through the outershaft 101 of the shaft assembly 100 and is located on another lateralside of the shaft guide axis SGA to be coupled to the intermediatefiring drive shaft portion 69600 (flexible drive shaft segment 176) thatis supported in the second passage 69026 in the shaft guide 69000. Thus,when the intermediate closure drive shaft portion 69300 and theintermediate firing drive shaft portion 69600 enter the shaft guideproximal end 69020, the intermediate closure drive shaft portion 69300and the intermediate firing drive shaft portion 69600 are in aside-by-side relationship or configuration (one on each side of theshaft guide axis SGA). When the intermediate closure drive shaft portion69300 and the intermediate firing drive shaft portion 69600 exit theshaft guide distal end in a vertically stacked relationship wherein theintermediate closure drive shaft portion 69300 is above the intermediatefiring drive shaft portion 69600.

In one instance, the first passage 69022 and the second passage 69026twist as they go from the shaft guide proximal end 69020 to the shaftguide distal end 69030. The shaft guide 69000 comprises a support forthe intermediate closure drive shaft portion 69300 and the intermediatefiring drive shaft portion 69600 that avoids forming a preferred bendplane. The shaft guide 69000 spans two, in-series articulation joints ofa multi-axis joint arrangement without forming a preferred bendingorientation. In at least one arrangement, the multi-axis jointarrangement facilitates articulation of the end effector through twoarticulation angles about articulation axes AA1-AA1, AA2-AA2, that areeach at least approximately 75 degrees in magnitude. The exteriorprofile of the shaft guide 69000 as well as each of the first passage69022 and the second passage 69026 can twist to minimize its bendingresistance by aligning its minimum moment of inertia plane to that ofthe articulation axes. In alternative arrangements, each of the firstpassage 69022 and the second passage 69026 may twist multiple timesbetween the shaft guide proximal end 69020 and the shaft guide distalend 69030. In such instances, for example, each of the first passage69022 and the second passage 69026 may pass through each of the firstreference plane FRP and the second reference plane SRP multiple times.

In accordance with at least one aspect of the present disclosure, theproximal end 69027 of the second passage 69026 opens through the shaftguide proximal end 69020 in a “first orientation” relative to theproximal end 69023 of the first passage 69022. In the exampleillustrated in FIG. 55, the proximal end 69027 of the second passage69026 is horizontally spaced from or “horizontally aligned” with theproximal end 69023 of the first passage 69022. Other first orientationsare contemplated. Also in accordance with at least one aspect of thepresent disclosure, the distal end 69029 of the second passage 69026 isoriented in a “second orientation” relative to the distal end 69025 ofthe first passage 69022 that differs from the first orientation. Forexample, as can be seen in FIG. 56, the second passage distal end 69029is located below the first passage distal end 69025. Stated another waythe first passage distal end 69025 and the second passage distal end69029 are “vertically stacked” with each other or “vertically aligned”with each other. Other second orientations are contemplated. In stillother applications, the shaft guide 69000 may be installed in a reversedorientation between the surgical end effector and the shaft assembly sothat the shaft guide proximal end 69020 will actually be distal to theshaft guide distal end 69030. Thus, in such arrangement, the driveshafts entering the shaft guide 69000 will be vertically stackedrelative to each other and they will exit the shaft guide 69000 in ahorizontally spaced orientation, for example.

FIG. 63 illustrates a portion of another surgical stapling instrument70010 that comprises an elongate shaft assembly 100 that may be operablycoupled to a housing of a surgical instrument or portion of a roboticsystem of the various types and forms described and contemplated herein.The elongate shaft assembly 100 is operably coupled to an end effector200 by an articulation joint assembly 71000. The end effector 200 maycomprise a variety of different end effectors configured to perform aparticular surgical function. In the illustrated arrangement, the endeffector 200 is configured to clamp, staple, and cut tissue of apatient. However, other forms of end effectors may be employed. In thisexample, the end effector 200 comprises a cartridge jaw 201 and an anviljaw 203. The anvil jaw 203 is pivotable relative to the cartridge jaw203 to clamp tissue between the anvil jaw 203 and the cartridge jaw 201.Once tissue is clamped between the jaws 201, 203, the surgical staplinginstrument 70010 may be actuated to advance a firing member through thejaws 201, 203 to staple and cut tissue with the end effector 200 asdiscussed in greater detail below.

To open and close the anvil jaw 203 relative to the cartridge jaw 201, aclosure drive 250 is provided. See FIG. 64. The closure drive 250 isactuated by a flexible closure drive shaft 72000 that may comprise aflexible shaft segment (e.g., torsion cable, laser cut shaft, etc.) or acombination of rigid segment(s) and flexible segment(s), for examplethat operably interface with a source of rotary closure motionssupported in or by the housing or robotic system. Discussed in greaterdetail below, the flexible closure drive shaft 72000 is driven by aclosure input shaft 72010 that extends through the shaft assembly 100and operably interfaces with a source of rotary closure motions (e.g., amotor) supported in a housing of the surgical instrument or portion of arobotic system. The flexible closure drive shaft 72000 transmits rotaryactuation motions through the articulation joint assembly 71000. Theclosure drive 250 comprises a closure screw 251 and a closure wedge 255that is threadably coupled to the closure screw 251. The closure wedge255 is configured to positively cam the anvil jaw 203 open and closed inthe various manners described herein. The closure screw 251 is supportedby a first support body 258 and a second support body 259 secured withinthe channel 210. See FIG. 64.

To move the anvil jaw 203 between a clamped position and an unclampedposition, the closure input shaft 72010 is actuated (rotated) to actuate(rotate) the flexible closure drive shaft 72000. The flexible closuredrive shaft 72000 is coupled to the closure screw 251 by a coupler 72012and is configured to rotate the closure screw 251, which displaces theclosure wedge 255. For example, the closure wedge 255 is threadablycoupled to the closure screw 251 and rotational travel of the closurewedge 255 with the staple cartridge 220 is restrained. The closure screw251 drives the closure wedge 255 proximally or distally depending onwhich direction the closure screw 251 is rotated.

As discussed above, the surgical stapling instrument 70010 may beactuated to advance a firing member through the jaws 201, 203 to stapleand cut tissue with the end effector 200. As was discussed above,staples that are stored in the staple cartridge 220 are deployed when asled (not shown in FIG. 64) is driven distally through the staplecartridge 220. A knife (not shown) is operably supported on the sled andserves to cut tissue clamped between the anvil 203 and the cartridge 220as the sled is driven distally through the staple cartridge 220 by afiring member 270. The firing member 270 is driven distally through theend effector 200 by a firing drive 260. The firing drive 260 is actuatedby a flexible firing drive shaft 72100. The flexible firing drive shaft72100 comprises a flexible shaft segment (e.g., torsion cable, laser cutflexible shaft, etc.) or a combination of rigid and flexible segments,for example, that operably interface with a source of rotary firingmotions (e.g., firing drive motor) that is supported in or by thehousing of the surgical instrument or robotic system. The flexiblefiring drive shaft 72100 is driven by a firing input shaft 72110 thatextends through the shaft assembly 100. The flexible firing drive shaft72100 transmits rotary actuation motions through the articulation jointassembly 71000 to a firing screw 261 that comprises a portion of thefiring drive 260. The firing screw 261 comprises journals supportedwithin bearings in the support member 259 and the channel 210. Thefiring screw 261 comprises a proximal end 262 supported within thesupport member 259 and the channel 210, a distal end 263 supportedwithin the channel 210, and threads 265 extending along a portion of thelength of the firing screw 261.

The firing member 270 is threadably coupled to the firing screw 261 suchthat as the firing screw 261 is rotated, the firing member 270 isadvanced distally or retracted proximally along the firing screw 261.Specifically, the firing member 270 comprises a body portion 271comprising a hollow passage 272 defined therein. The firing screw 261 isconfigured to be received within the hollow passage 272 and isconfigured to be threadably coupled with a threaded component 273 of thefiring member 270. Thus, as the firing screw 261 is rotated, thethreaded component 273 applies a linear force to the body portion 271 toadvance the firing member 270 distally or retract the firing member 270proximally. As the firing member 270 is advanced distally, the firingmember 270 pushes the sled (not shown) that is movable supported in thestaple cartridge 220. Distal movement of the sled causes the ejection ofthe staples by engaging the plurality of staple drivers, as describedabove. The flexible firing drive shaft 72100 is coupled to the firingscrew 261 by a coupler 72112 and is configured to rotate the firingscrew 251, which displaces the firing member 270.

Still referring to FIG. 64, one form of the articulation joint assembly71000 comprises a proximal mounting member 71100 that is configured tointerface with the shaft assembly 100 of the surgical staplinginstrument 70010. For example, the proximal mounting member 71100 may bewelded or attached to a distal portion of the shaft assembly 100 by anysuitable means. In other arrangements, the proximal mounting member71100 may comprise a portion of the shaft assembly 100. The articulationjoint assembly 71000 further comprises a distal joint shaft component ordistal mounting member 71300. The distal mounting member 71300 may bewelded or attached to a proximal portion of the surgical end effector200 by any suitable means. In the illustrated arrangement for example,the distal mounting member 71300 is attached to the proximal end of thecartridge jaw 201 by a retention ring 146. In other arrangements, thedistal mounting member 71300 may comprise a portion of the surgical endeffector 200.

In the non-limiting example illustrated in FIGS. 63 and 64, the proximalmounting member 71100 comprises a proximal shaft hole 71110 that isaxially aligned on a shaft axis SA-SA that is defined by the shaftassembly 100. See FIG. 69. Similarly, the distal mounting member 71300comprises a distal shaft hole 71310. The distal shaft hole 71310 mayhave a diameter that is the same or similar to a diameter of theproximal shaft hole 71110. When the surgical end effector 200 is alignedon the shaft axis SA-SA with the shaft assembly 100, the distal shafthole 71310 is aligned with the proximal shaft hole 71110.

Referring now to FIGS. 65-69, in at least one non-limiting example, thearticulation joint assembly 71000 further comprises a linkage assembly71400 that is coupled to and extends between the proximal mountingmember 71100 and the distal mounting member 71300. In at least one form,the linkage assembly 71400 comprises a plurality of articulation linkmembers that extend between the proximal mounting member 71100 and thedistal mounting member 71300 and are attached thereto. The illustratednon-limiting example comprises three articulation link members 71500A,71500B and 71500C. Other numbers of articulation link members arecontemplated. For example, a linkage assembly that only comprises twolink members will work, but such linkage assembly may only facilitatearticulation through a single plane.

In one non-limiting arrangement, articulation link member 71500Acomprises a proximal link end 71510A, a link distal link end 71520A, anda link body 71530A. The proximal link end 71510A is coupled to theproximal mounting member 71100 at a first proximal attachment location71120A by a first proximal joint assembly 71130A. In the illustratedexample, the first proximal joint assembly 71130A comprises a pair offirst proximal attachment lugs 71132A that protrude from the proximalmounting member 71100. A first proximal attachment link 71134A ispivotally coupled to the first proximal attachment lugs 71132A by afirst proximal joint pin 71136A that defines a first proximal joint axisFPJA₁. The first proximal attachment link 71134A is pivotally attachedto the proximal link end 71510A by a second proximal joint pin 71138Athat defines a second proximal joint axis SPJA₂ that is transverse tothe first proximal joint axis FPJA₁ as well as the shaft axis SA-SA.

In the illustrated example, the distal link end 71520A is coupled to thedistal mounting member 71300 at a first distal attachment location71320A by a first distal joint assembly 71330A. In the illustratedexample, the first distal joint assembly 71330A comprises a pair offirst distal attachment lugs 71332A that protrude from the distalmounting member 71300. A first distal attachment link 71334A ispivotally coupled to the first distal attachment lugs 71332A by a firstdistal joint pin 71336A that defines a first distal joint axis FDJA₁.The first distal attachment link 711334A is pivotally attached to thedistal link end 71520A by a second distal joint pin 71338A that definesa second distal joint axis SDJA₂ that is transverse to the first distaljoint axis FDJA₁ as well as the shaft axis SA-SA.

In one non-limiting arrangement, articulation link member 71500Bcomprises a proximal link end 71510B, a link distal link end 71520B, anda link body 71530B. The proximal link end 71510B is coupled to theproximal mounting member 71100 at a second proximal attachment location71120B by a second proximal joint assembly 71130B. In the illustratedexample, the second proximal joint assembly 71130B comprises a pair ofsecond proximal attachment lugs 71132B that protrude from the proximalmounting member 71100. A second proximal attachment link 71134B ispivotally coupled to the second proximal attachment lugs 71132B by afirst proximal joint pin 71136B that defines a third proximal joint axisTPJA₃. The second proximal attachment link 71134B is pivotally attachedto the proximal link end 71510B by a second proximal joint pin 71138Bthat defines a fourth proximal joint axis FPJA₄ that is transverse tothe third proximal joint axis TPJA₃ as well as the shaft axis SA-SA.

In the illustrated example, the distal link end 71520B is coupled to thedistal mounting member 71300 at a second distal attachment location71320B by a second distal joint assembly 71330B. In the illustratedexample, the second distal joint assembly 71330B comprises a pair ofsecond distal attachment lugs 71332B that protrude from the distalmounting member 71300. A second distal attachment link 71334B ispivotally coupled to the second distal attachment lugs 71332B by a firstdistal joint pin 71336B that defines a third distal joint axis TDJA₃.The second distal attachment link 71334B is pivotally attached to thedistal link end 71520B by a second distal joint pin 71338B that definesa fourth distal joint axis FDJA₄ that is transverse to the third distaljoint axis TDJA₃ as well as the shaft axis SA-SA.

In one non-limiting arrangement, articulation link member 71500Ccomprises a proximal link end 71510C, a link distal link end 71520C, anda link body 71530C. The proximal link end 71510C is coupled to theproximal mounting member 71100 at a third proximal attachment location71120C by a third proximal joint assembly 71130C. In the illustratedexample, the third proximal joint assembly 71130C comprises a pair ofthird proximal attachment lugs 71132C that protrude from the proximalmounting member 71100. A third proximal attachment link 71134C ispivotally coupled to the third proximal attachment lugs 71132C by afirst proximal joint pin 71136C that defines a fifth proximal joint axisFPJA₅. The third proximal attachment link 71134C is pivotally attachedto the proximal link end 71510C by a second proximal joint pin 71138Cthat defines a sixth proximal joint axis SPJA₆ that is transverse to thefifth proximal joint axis TPJA₅ as well as the shaft axis SA-SA. In onenon-limiting example, the first proximal attachment location 71120A, thesecond proximal attachment location 71120B, and the third proximalattachment location 71120C are equally spaced about the shaft axisSA-SA. Stated another way, the angles between the first proximalattachment location 71120A, the second proximal attachment location71120B, and the third proximal attachment location 71120C are eachapproximately 120°.

In the illustrated example, the distal link end 71520C is coupled to thedistal mounting member 71300 at a third distal attachment location71320C by a third distal joint assembly 71330C. In the illustratedexample, the third distal joint assembly 71330C comprises a pair ofthird distal attachment lugs 71332C that protrude from the distalmounting member 71300. A third distal attachment link 71334C ispivotally coupled to the third distal attachment lugs 71332C by a firstdistal joint pin 71336C that defines a fifth distal joint axis FDJA₃.The third distal attachment link 71334C is pivotally attached to thedistal link end 71520C by a second distal joint pin 71338C that definesa sixth distal joint axis SDJA₆ that is transverse to the fifth distaljoint axis FDJA₅ as well as the shaft axis SA-SA. In one non-limitingexample, the first distal attachment location 71320A, the second distalattachment location 71320B, and the third distal attachment location71320C are equally spaced about the shaft axis SA-SA. Stated anotherway, the angles between the first distal attachment location 71320A, thesecond distal attachment location 71320B, and the third distalattachment location 71320C are each approximately 120°. In onearrangement, when the surgical end effector 200 is in an unarticulatedposition or, stated another way, axially aligned with the shaft assembly100 on the shaft axis SA-SA, the first distal attachment location 71320Ais diametrically opposite to the first proximal attachment location71120A; the second distal attachment location 71320B is diametricallyopposite to the second proximal attachment location 71120B; and thethird distal attachment location 71320C is diametrically opposite to thethird proximal attachment location 71120C.

In one aspect, the proximal shaft hole 71110 in the proximal mountingmember 71100 and the distal shaft hole 71310 serve to define a centralopen passage area 72900. FIG. 70 illustrates an end view of articulationlink member 71500A. As can be seen in FIG. 70, the link body 71530Acomprises a curved surface 71532A that curves around the central openpassage area 79200. The link body 72530B similarly has a curve surface71532B and the link body 71530C has a curved surface 71532C. The curvedsurfaces 71532A, 71532B, 7532C cooperate to maintain the central openpassage area 72900 regardless of the articulated position of thearticulation joint assembly 71000. See e.g., FIGS. 66-67. It will befurther appreciated that the length of the articulation joint assembly71000 remains relatively constant during such articulationmotions/positions. Stated another way, the distance DA between theproximal mounting member 71100 and the distal mounting member 71300remains the same regardless of the articulation angle. Such range ofarticulation is facilitated because each of the link members 71500A,71500B, 71500C may move (rotate) through a link path LP of approximately180 degrees, for example. See FIG. 70.

FIG. 71 illustrates one form of a shaft guide 73000 that is configuredto extend between the proximal mounting member 71100 and the distalmounting member 71300 while supporting the flexible closure drive shaft72000 and the flexible firing drive shaft 72100 therein. In one aspect,the shaft guide 73000 comprises a shaft guide proximal end 73010, ashaft guide distal end 73020, and a central body portion 73030. Theshaft guide proximal end 73010 comprises a proximal mounting collar73012 that is configured to be rotatably supported within the proximalshaft hole 71110 in the proximal mounting member 71100. Similarly, theshaft guide distal end 73020 comprises a distal mounting collar 73022that is configured to be rotatably supported in the distal shaft hole71310 in the distal mounting member 71300. Such arrangement facilitatesrotation of the shaft guide 73000 relative to the proximal mountingmember 71100 and the distal mounting member 71300 while remainingaffixed thereto. In another arrangement, the proximal mounting collar73012 may additionally be configured relative to the proximal mountingmember 71100 to facilitate some axial movement relative thereto as well.In addition to or in the alternative, the distal mounting collar 73022may be configured to facilitate some axial movement relative to thedistal mounting member 71300.

In one arrangement, the entire central body portion 73030 is flexibleand may be fabricated from a ductile material (e.g., polypropylene, lowdensity polyethylene, liquid crystal polymer (LCP), Nylon, etc.) that isconfigured to facilitate twisting flexure when the end effector isarticulated. In another arrangement, for example, the central bodyportion 73030 comprises a relative rigid hollow center segment that maycomprise a polymer, metal, etc. and be coupled to a proximal flexiblesegment that is coupled to the proximal mounting collar 73012 and adistal flexible segment that is coupled to the distal mounting collar73022. The proximal flexible segment and the distal flexible segment maybe fabricated from polymer, rubber, etc. that is more flexible than thecenter segment. In the embodiment illustrated in FIGS. 71 and 72, theshaft guide 73000 is fabricated from a single flexible material(polymer, rubber, etc.) and additionally includes a proximal flexibleribbed segment 73032 and a distal flexible ribbed segment 73034 formedtherein to facilitate additional flexibility.

In the illustrated example, the shaft guide 73000 defines a centralshaft guide axis SGA that extends from the shaft guide proximal end73010 to the shaft guide distal end 73020. The shaft guide 73000 furthercomprises a first passage 73040 that opens through the proximal mountingcollar 73012 on a first side RP₁ of a reference plane RP that extendstransversely through the shaft guide axis SGA. In the illustratedarrangement, the first passage 73040 is configured to operably supportthe portion of the flexible closure drive shaft 72000 that spans betweenthe proximal mounting member 71100 and the distal mounting member 71300.As can be seen in FIG. 71, in at least one arrangement, the firstpassage 73040 passes through the reference plane RP at least two timesand opens through the distal mounting collar 73022 on the first side RP₁of the reference plane RP.

In the illustrated example, the shaft guide 73000 further comprises asecond passage 73050 that opens through the proximal mounting collar73012 on a second side RP2 of the reference plane RP. In the illustratedarrangement, the second passage 73050 is configured to operably supportthe portion of the flexible firing drive shaft 72100 that spans betweenthe proximal mounting member 71100 and the distal mounting member 71300.As can be seen in FIG. 71, in at least one arrangement, the secondpassage 73050 passes through the reference plane RP at least two timesand opens through the distal mounting collar 73022 on the second sideRP2 of the reference plane RP. Such arrangement serves to operablysupport the flexible closure drive shaft 72000 and the flexible firingdrive shaft 72100 regardless of the articulated position of the endeffector 200. In addition, such “twisted” arrangement of the firstpassage 73040 and the second passage 73050 forms a non-preferentialbending plane through the shaft guide. In other arrangements, the shaftguide 73000 may be coupled to the proximal mounting member 71100 and thedistal mounting member 71300 to facilitate relative rotationtherebetween.

Referring now to FIGS. 64 and 74, in at least one arrangement, thesurgical instrument comprises an articulation system 74000 thatcomprises a horizontal articulation drive 74100 and a verticalarticulation drive 74200. In one aspect, the horizontal articulationdrive 74100 comprises a horizontal articulation cable 74110 that isjournaled on a horizontal drive pulley 74120 that may be supported in orby the housing or robotic system. In other arrangements, the horizontaldrive pulley 74120 may be supported in a portion of the shaft assembly100. In at least one embodiment, the horizontal drive pulley 74120comprises a horizontal drive gear 74122 that is in meshing engagementwith a horizontal drive rack 74124. The horizontal drive rack 74124 isconfigured to be driven axially by a corresponding motor drive unit (notshown) supported in or by the housing or robotic system.

As can be seen in FIG. 64, the horizontal articulation cable 74110comprises a first horizontal cable end portion 74112 that extendsthrough a corresponding passage in the proximal mounting member 71100and is attached to the distal mounting member 71300. The horizontalarticulation cable 74110 further comprises a second horizontal cable endportion 74114 that extends through a corresponding passage in theproximal mounting member 71100 and is attached to the distal mountingmember 71300. Rotation of the horizontal drive pulley 71420 in a firstdirection will cause the end effector 200 to articulate in a firsthorizontal direction and rotation of the horizontal drive pulley 71420in a second direction will cause the end effector 200 to articulate in asecond horizontal direction (arrows HD in FIG. 63).

Still referring to FIGS. 64 and 74, the vertical articulation drive74200 comprises a vertical articulation cable 74210 that is journaled ona vertical drive pulley 74220 that may be supported in or by the housingor robotic system. In other arrangements, the vertical drive pulley74220 may be supported in a portion of the shaft assembly 100. In atleast one embodiment, the vertical drive pulley 74220 comprises avertical drive gear (not shown) that is in meshing engagement with avertical drive rack 74224. The vertical drive rack 74224 is configuredto be driven axially by a corresponding motor drive unit supported in orby the housing or robotic system.

As can be seen in FIG. 64, the vertical articulation cable 74210comprises a first vertical cable end portion 74212 that extends througha corresponding passage in the proximal mounting member 71100 and isattached to the distal mounting member 71300. The vertical articulationcable 74210 further comprises a second horizontal cable end portion74214 that extends through a corresponding passage in the proximalmounting member 71100 and is attached to the distal mounting member71300. Rotation of the vertical drive pulley 74220 in a first directionwill cause the end effector 200 to articulate in a first verticaldirection and rotation of the vertical drive pulley 74220 in a seconddirection will cause the end effector 200 to articulate in a secondvertical direction (arrows VD in FIG. 63). When the horizontalarticulation drive 74100 and a vertical articulation drive 74200 areoperated in concert, they can articulate the end effector in anycombination of planes creating a three dimensional cone of articulation.In various arrangements springs may be employed in connection with thecables and or the drive pulleys to reduce/minimize backlash duringoperation.

FIGS. 75 and 76 illustrate another articulatable surgical end effector75000 that is configured to articulate in a single plane through anarticulation angle AAG that is approximately sixty five degrees or more.Such articulatable end effectors may be particularly useful inperforming a lower anterior resection (LAR) of the colon, for example.In one instance, the surgical end effector 75000 comprises a surgicalstapling device that is capable of cutting and stapling tissue. Otherapplications may employ a surgical end effector that is configured tocut and fasten tissue with ultrasound, harmonic, radio frequency energy,etc. In the illustrated example, the surgical end effector 75000 issubstantially similar to end effector 200 described above, except forthe differences discussed herein.

The illustrated surgical end effector 75000, for example, comprises afirst jaw 201 and an anvil jaw 203, the various details of which wereprovided above. The surgical end effector further comprises a distaljoint component 75450 that is similar to the joint component 450discussed above. In at least one arrangement, the distal joint component75450 is attached to the first jaw 201 by a retention ring 358 in thevarious manners described herein. In accordance with one aspect, adistal articulation cam 75500 is coupled to the distal joint component75450. The distal articulation cam 75500 is configured to camminglyinterface with a proximal articulation cam 75600 that operablyinterfaces with a shaft assembly 75410.

In accordance with at least one aspect, the shaft assembly 75410 issubstantially similar to shaft assembly 410 described herein except forthe noted differences. In one example, the shaft assembly comprises anouter shaft 75411 that operably interfaces with a proximal shaft jointcomponent 75330. In accordance with one aspect, the proximalarticulation cam 75600 is supported by the proximal shaft jointcomponent 75330 for rotation about the shaft axis SA. In one embodiment,for example, the proximal articulation cam 75600 comprises a ring gear75610 that is configured to meshingly interface with an articulationdrive gear 75710 that is attached to an articulation drive shaft 75700that is rotatably supported in the shaft assembly 75410. Thearticulation drive shaft 75700 operably interfaces with a source ofrotary motion (e.g., a motor, etc.) that is supported in or by thehousing or robotic system. Rotation of the articulation drive shaft75700 in a first rotary direction will cause a proximal cam face 75620on the proximal articulation cam 75600 to cammingly interface with adistal cam face 75520 on the distal articulation cam 75500 to articulatethe surgical end effector 75000 through the articulation angle AAG.Continued rotation of the articulation drive shaft 75700 in the firstdirection will cause the surgical end effector to articulate through asingle articulation plane until the surgical end effector 75000 reachesthe maximum articulated position (articulation angle AAG equalsapproximately 65°) illustrated in FIG. 76, for example. Rotation of thearticulation drive shaft 75700 in a second rotary direction will causethe proximal articulation cam 75600 and distal articulation cam 75500 tocammingly drive the surgical end effector 75000 back to theunarticulated position illustrated in FIG. 75.

The embodiment depicted in FIGS. 75 and 76, in accordance with oneaspect of the present disclosure, may employ the closure drive systemand firing drive system depicted in FIGS. 44-48 that were described indetail above. It will be appreciated that the closure drive system andfiring drive system serve to maintain the distal cam face 75520 incamming engagement with the proximal cam face 75620. FIGS. 75 and 76 are“plan” or “top” views which only illustrate the closure drivearrangement with it being understood that the firing drive arrangementis located directly beneath the closure drive arrangement in the mannersdescribed herein. For example, as can be seen in FIGS. 75 and 76, theclosure drive arrangement comprises a proximal closure drive shaftportion 68002, an intermediate closure drive shaft portion 68100, and adistal closure drive shaft portion 68300 that operably interfaces withclosure components described herein to open and close the anvil 203. Aswas also described above, a proximal closure drive shaft 68010 and adistal closure drive shaft 68300 are attached to a closure couplermember 68110 for movement relative thereto. The proximal closure driveshaft 68010 may operably interface with a source of rotary closuremotions (e.g., a motor, etc.) that is operably supported by or in ahousing or portion of a robotic system, for example. Rotation of theproximal closure drive shaft 68010 in a first direction may result inthe closure of the anvil 203 and rotation of the proximal closure driveshaft 68010 in a second rotary direction, will result in the anvil 203moving from a closed position to an open position in the mannersdescribed herein. The firing drive system that may be employed inconnection with this embodiment was described in detail above and willnot be repeated here for the sake of brevity.

Other embodiments may employ the shaft embodiments comprisinguniversally movable joints 60200 in the various manners and arrangementsdisclosed herein. The distal articulation cam 75500 and the proximalarticulation cam 75500 define an articulation region 75100 andfacilitate single plane, single direction, high-degree of articulationutilizing a rotating cam twist joint.

Many of the surgical instrument systems described herein are motivatedby an electric motor; however, the surgical instrument systems describedherein can be motivated in any suitable manner. In various instances,the surgical instrument systems described herein can be motivated by amanually-operated trigger, for example. In certain instances, the motorsdisclosed herein may comprise a portion or portions of a roboticallycontrolled system. Moreover, any of the end effectors and/or toolassemblies disclosed herein can be utilized with a robotic surgicalinstrument system. U.S. patent application Ser. No. 13/118,241, entitledSURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS, now U.S. Pat. No. 9,072,535, for example, disclosesseveral examples of a robotic surgical instrument system in greaterdetail.

The surgical instrument systems described herein have been described inconnection with the deployment and deformation of staples; however, theembodiments described herein are not so limited. Various embodiments areenvisioned which deploy fasteners other than staples, such as clamps ortacks, for example. Moreover, various embodiments are envisioned whichutilize any suitable means for sealing tissue. For instance, an endeffector in accordance with various embodiments can comprise electrodesconfigured to heat and seal the tissue. Also, for instance, an endeffector in accordance with certain embodiments can apply vibrationalenergy to seal the tissue.

EXAMPLES—SET NO. 1 Example 1

A universally movable drive shaft for a surgical instrument, wherein theuniversally movable drive shaft comprises a first movable joint thatcomprises a first joint spine that defines a first axis and a secondaxis that is transverse to the first axis. The first movable jointfurther comprises a first U-shaped bridge that is movably andnon-removably journaled on the first joint spine for pivotal travelrelative thereto about the first axis. The first movable joint furthercomprises a second U-shaped bridge that is movably and non-removablyjournaled on the first joint spine for pivotal travel relative theretoabout the second axis. The second U-shaped bridge further comprises athird U-shaped bridge of a second movable joint. The second movablejoint comprises a second joint spine that defines a third axis and afourth axis that is transverse to the third axis. The third U-shapedbridge is movably and non-removably journaled on the second joint spinefor pivotal travel relative thereto about the fourth axis. The secondmovable joint further comprises a fourth U-shaped bridge that is movablyand non-removably journaled on the second joint spine for pivotal travelrelative thereto about the third axis

Example 2

The universally movable drive shaft of Example 1, wherein the fourthU-shaped bridge further comprises a fifth U-shaped bridge of a thirdmovable joint. The third movable joint comprises a third joint spinethat defines a fifth axis and a sixth axis that is transverse to thefifth axis. The fifth U-shaped bridge is movably and non-removablyjournaled on the third joint spine for pivotal travel relative theretoabout the sixth axis. The third movable joint further comprises a sixthU-shaped bridge that is movably and non-removably journaled on the thirdjoint spine for pivotal travel relative thereto about the fifth axis.

Example 3

The universally movable drive shaft of Examples 1 or 2, wherein thefirst U-shaped bridge comprises a first joint cap that is rotatablysupported on a first conical portion of the first joint spine forrotatable travel therearound about the first axis and the first jointcap is spaced from the first conical portion by a first joint space. Asecond joint cap is rotatably supported on a second conical portion ofthe first joint spine for rotational travel therearound about the firstaxis, wherein the second joint cap is spaced from the second conicalportion by a second joint space. The second U-shaped bridge comprises afirst joint ring that is journaled on a portion of the first joint spinefor rotation therearound about the second axis, wherein the first jointring is retained on the first joint spine by a first flared end of thefirst joint spine, and wherein the first joint ring is spaced from theportion of the first joint spine by a third joint space. A second jointring is journaled on another portion of the first joint spine forrotation therearound about the second axis, wherein the second jointring is spaced from the another portion of the first joint spine by afourth joint space.

Example 4

The universally movable drive shaft of Examples 1, 2 or 3, wherein theuniversally movable drive shaft is fabricated from a build material thatis converted from a first state to a second state by a manufacturingprocess.

Example 5

The universally movable drive shaft of Example 4, wherein themanufacturing process comprises a three dimensional printing process.

Example 6

The universally movable drive shaft of Example 4 or 5, wherein the firstjoint space is configured to contain a first amount of the buildmaterial in the first state during formation of the first universallymovable drive shaft and exit therefrom after the formation. The secondjoint space is configured to contain a second amount of the buildmaterial in the first state therein during the formation and exittherefrom after the formation. The third joint space is configured tocontain a third amount of the build material in the first state duringthe formation and exit therefrom after the formation. The fourth jointspace is configured to contain a fourth amount of the build material inthe first state during the formation and exit therefrom after theformation.

Example 7

A universally movable joint for a shaft of a surgical instrument. Theuniversally movable joint comprises a joint spine that defines a firstaxis and a second axis that is transverse to the first axis. The jointspine comprises a first axle segment and a second axle segment that areeach aligned on the first axis. The first axle segment comprises aflared first end and the second axle segment comprises a flared secondend. The joint spine further comprises a third axle segment and a fourthaxle segment that are each aligned on the second axis. The universallymovable joint further comprises a first U-joint that is pivotallyjournaled on the joint spine for pivotal travel relative thereto aboutthe first axis. The first U-joint comprises a first joint ring journaledon the first axle segment for rotation therearound and is retainedthereon by the flared first end. The first U-joint further comprises asecond joint ring that is journaled on the second axle segment forrotation therearound and is retained thereon by the flared second end.The first U-joint further comprises a first bridge that extends betweenthe first joint ring and the second joint ring. The universally movablejoint further comprises a second U-joint that is pivotally journaled onthe joint spine for pivotal travel relative thereto about the secondaxis. The second U-joint comprises a third joint cap that is rotatablyjournaled on the third axle segment for rotation therearound about thesecond axis. The second U-joint further comprises a fourth joint capthat is rotatably journaled on the fourth axle segment for rotationtherearound about the second axis. The second U-joint further comprisesa second bridge that extends between the third joint cap and the fourthjoint cap to retain the third joint cap on the third axle segment andthe fourth joint cap on the fourth axle segment.

Example 8

The universally movable joint of Example 7, wherein the third axlesegment terminates in a third conical end, and wherein the fourth axlesegment terminates in a fourth conical end.

Example 9

The universally movable joint of Example 8, wherein the first joint ringcomprises a first joint ring inner surface, wherein the first joint ringinner surface is spaced from the first axle segment and the flared firstend to define a first joint space. The second joint ring comprises asecond joint ring inner surface, wherein the second joint ring innersurface is spaced from the second axle segment and the flared second endto define a second joint space. The third joint cap comprises a thirdaxle surface that is spaced from the third axle segment a third axlejoint space. A third conical surface is spaced from the third conicalend a third tapered joint space that communicates with the third axlejoint space to form a third joint space. A third exit hole extendsthrough the third joint cap and communicates with the third joint space.The fourth joint cap comprises a fourth axle surface that is spaced fromthe fourth axle segment a fourth axle joint space. A fourth conicalsurface is spaced from the fourth conical end a fourth tapered jointspace that communicates with the fourth axle joint space to form afourth joint space. A fourth exit hole extends through the fourth jointcap and communicates with the fourth joint space.

Example 10

The universally movable joint of Examples 7 or 8, wherein theuniversally movable joint further comprises a first joint space betweenthe first ring and the first axle. A second joint space is between thesecond ring and the second axle. A third joint space is between thethird joint cap and the third axle segment and a fourth joint space isbetween the fourth joint cap and the fourth axle segment.

Example 11

The universally movable joint of Examples 7, 8, 9 or 10, wherein theuniversally movable joint is fabricated from a build material that isconverted from a first state to a second state by a manufacturingprocess.

Example 12

The universally movable joint of Example 11, wherein the manufacturingprocess comprises a three dimensional printing process.

Example 13

The universally movable joint of Examples 11 or 12, wherein the firstjoint space is configured to contain a first amount of the buildmaterial in the first state therein during formation of the multi-planarmovable joint. The second joint space is configured to contain a secondamount of the build material in the first state therein during theformation. The third joint space is configured to contain a third amountof the build material in the first state during the formation and thefourth joint space is configured to contain a fourth amount of the buildmaterial in the first state during the formation.

Example 14

The universally movable joint of Example 13, wherein the first jointspace is configured to enable at least some of the first amount of thebuild material in the first state to exit therefrom after the formationof the universally movable joint. The second joint space is configuredto enable at least some of the second amount of the build material inthe first state to exit therefrom after the formation. The third jointcap comprises a third exit hole sized to permit at least some of thethird amount of the build material in the first state to exittherethrough after the formation. The fourth joint cap comprises afourth exit hole sized to permit at least some of the fourth amount ofthe build material in the first state to exit therethrough after theformation.

Example 15

The universally movable joint of Example 14, wherein the first jointring comprises a first joint ring outer surface. The third joint capcomprises a third joint cap outer surface and the fourth joint capcomprises a fourth joint cap outer surface. The first joint ring outersurface is spaced from the third joint cap outer surface a first filletspace. The first joint ring outer surface is spaced from the fourthjoint cap surface a second fillet space. The second joint ring comprisesa second joint ring outer surface that is spaced from the third capouter surface a third fillet space. The second joint ring outer surfaceis spaced from the fourth cap outer surface a fourth fillet space.

Example 16

The universally movable joint of Example 15, wherein the first filletspace is configured to permit at least some other of the third amount ofthe build material in the first state to exit therethrough after theformation. The second fillet space is configured to permit at least someother of the fourth amount of the build material in the first state toexit therethrough after the formation. The third fillet space and thefourth fillet space are each configured to permit at least some other ofthe second amount of the build material in the first state to exittherethrough.

Example 17

The universally movable joint of Examples 7, 8 , 9, 10, 11, 12, 13, 14,15 or 16, wherein the universally movable joint further comprises amounting member that protrudes from one of the first bridge and thesecond bridge.

Example 18

The universally movable joint of Examples 11, 12, 13, 14, 15, 16 or 17,wherein a support material that differs from the build material iscontained within the first joint space, the second joint space, thethird joint space, and the fourth joint space during the formation.

Example 19

The universally movable joint of Examples 7, 8, 9, 10, 11, 12, 13, 14,15, 16, 17 or 18, wherein the joint spine is formed from a first buildmaterial, and wherein the first U-joint and the second U-joint are eachformed from a second build material that differs from the first buildmaterial.

Example 20

An articulation joint assembly for facilitating multi-axis articulationof a surgical end effector relative to a shaft assembly of a surgicalinstrument, wherein the shaft assembly defines a shaft axis, and whereinthe articulation joint assembly comprises a proximal mounting memberthat is configured to interface with the shaft assembly. Thearticulation joint assembly further comprises a distal mounting memberthat is configured to interface with the surgical end effector. Thearticulation joint assembly additionally comprises a plurality ofarticulation link assemblies that are attached to the proximal mountingmember and the distal mounting member and extend therebetween. Eacharticulation link assembly comprises a pair of universally movablejoints. Each universally movable joint comprises a joint spine thatdefines a first axis and a second axis that is transverse to the firstaxis. The first axis and the second axis are transverse to the shaftaxis. A first bridge is movably and non-removably journaled on the jointspine for pivotal travel relative thereto about the first axis. A secondbridge is movably and non-removably journaled on the joint spine forpivotal travel relative thereto about the second axis. An attachmentmember protrudes from the second bridge and is configured to movablyaffix the universally movable joint to a corresponding one of theproximal mounting member and the distal mounting member. Thearticulation link assembly further comprises an elongate link thatprotrudes from the first bridge on one of the universally movable jointsof the pair of universally movable joints and the first bridge on theother one of the universally movable joints of the pair of universallymovable joints and extends therebetween.

Example 21

The articulation joint assembly of Example 20, wherein the elongate linkdefines a link axis that curves around the shaft axis and is notparallel thereto.

Example 22

The articulation joint assembly of Examples 20 or 21, wherein theattachment member of one of the universally movable joints is configuredto movably affix one of the universally movable joints to the proximalmounting member such that the universally movable joint is axiallymovable relative thereto. The attachment member of the other one of theuniversally movable joints is configured to movably affix the other oneof the universally movable joints to the distal mounting member suchthat the other one of the universally movable joints is axially movablerelative thereto.

Example 23

The articulation joint assembly of Examples 20, 21 or 22, wherein eachattachment member defines an attachment member axis that is parallel tothe shaft axis.

Example 24

The articulation joint assembly of Examples 20, 21, 22 or 23, whereinthe second bridge comprises a first joint cap that is rotatablysupported on a first conical portion of the joint spine for rotatabletravel therearound about the first axis and is spaced from the firstconical portion by a first joint space. The second bridge furthercomprises a second joint cap that is rotatably supported on a secondconical portion of the joint spine for rotational travel therearoundabout the first axis and is spaced from the second conical portion by asecond joint space. The first bridge comprises a first joint ring thatis journaled on a first axle portion of the joint spine for rotationtherearound about the second axis and is spaced from the first axleportion of the joint spine by a third joint space. The first bridgefurther comprises a second joint ring that is journaled on a second axleportion of the joint spine for rotation therearound about the secondaxis and is spaced from the second axle portion of the joint spine by afourth joint space.

Example 25

The articulation joint assembly of Examples 20, 21, 22, 23 or 24,wherein each articulation link assembly is fabricated from a buildmaterial that is converted from a first state to a second state by amanufacturing process.

Example 26

The articulation joint assembly of Example 25, wherein the manufacturingprocess comprises a three dimensional printing process.

Example 27

The articulation joint assembly of Examples 25 or 26, wherein the firstjoint space is configured to contain a first amount of the buildmaterial in the first state therein during formation of the articulationlink assembly and exit therefrom after the formation, wherein the secondjoint space is configured to contain a second amount of the buildmaterial in the first state therein during the formation and exittherefrom after the formation, wherein the third joint space isconfigured to contain a third amount of the build material in the firststate therein during the formation and exit therefrom after theformation, and wherein the fourth joint space is configured to contain afourth amount of the build material in the first state therein duringthe formation and exit therefrom after the formation.

Example 28

A method comprising providing a build material that is convertible froma first powdered state to a second solid state. The method furthercomprises converting a first amount of the build material from the firstpowdered state to the second solid state to form a first cross-shapedjoint spine, wherein the first cross-shaped joint spine defines a firstvertical axis and a first horizontal axis that is transverse to thefirst vertical axis. The method further comprises converting a secondamount of the build material from the first powdered state to the secondsolid state to form a first vertical joint member configured tonon-removably pivot on the first cross-shaped joint spine about thefirst vertical axis. The method additionally comprises converting athird amount of the build material from the first powdered state to thesecond solid state to form a first horizontal joint member configured tonon-removably pivot on the first cross-shaped joint spine about thefirst horizontal axis. The method also comprises evacuating all amountsof the build material remaining in the first powdered state from betweenthe first cross-shaped joint spine, the vertical joint member, and thehorizontal joint member.

Example 29

The method of Example 28, wherein converting a first amount of the buildmaterial from the first powdered state to the second solid state methodfurther comprises forming a second cross-shaped joint spine, wherein thesecond cross-shaped joint spine defines a second vertical axis and asecond horizontal axis that is transverse to the second vertical axis.Converting a second amount of the build material from the first powderedstate to the second solid state to form a first vertical joint memberfurther comprises forming a second vertical joint member that isconfigured to non-removably pivot on the second cross-shaped joint spineabout the second vertical axis. Converting a third amount of the buildmaterial from the first powdered state to the second solid state to forma first horizontal joint member further comprises forming a secondhorizontal joint member that protrudes from the first vertical jointmember and is configured to non-removably pivot on the secondcross-shaped joint spine about the second horizontal axis.

Example 30

The method of Example 29, wherein converting a first amount of the buildmaterial from the first powdered state to the second solid state furthercomprises forming a third cross-shaped joint spine that defines a thirdvertical axis and a third horizontal axis that is transverse to thethird vertical axis. Converting a second amount of the build materialfrom the first powdered state to the second solid state to form a firstvertical joint member further comprises forming a third vertical jointmember that is configured to non-removably pivot on the thirdcross-shaped joint spine about the third vertical axis. Converting athird amount of the build material from the first powdered state to thesecond solid state to form a first horizontal joint member furthercomprises forming a third horizontal joint member that protrudes fromthe second vertical joint member and is configured to non-removablypivot on the third cross-shaped joint spine about the third horizontalaxis.

EXAMPLES—SET NO. 2 Example 1

A shaft guide for a surgical instrument that includes a shaft assemblythat defines a shaft axis and a surgical end effector that is operablycoupled to the shaft assembly by an articulation joint. The articulationjoint facilitates articulation of the surgical end effector about afirst articulation axis that is transverse to the shaft axis and asecond articulation axis that is transverse to the shaft axis and thefirst articulation axis. The shaft guide comprises a shaft guide bodythat is sized to span across the articulation joint and the firstarticulation axis and the second articulation axis. The shaft guide bodycomprises a shaft guide proximal end and a shaft guide distal end. Afirst passage extends through the shaft guide body and comprises firstpassage proximal opening in the shaft guide proximal end and a firstpassage distal opening in the shaft guide distal end. A second passageextends through the shaft guide body and comprises a second passageproximal opening in the shaft guide proximal end and a second passagedistal opening in the shaft guide distal end. The second passageproximal opening is oriented in a first orientation relative to thefirst passage proximal opening and the second passage distal opening isoriented in a second orientation relative to the first passage distalopening in a second orientation that differs from the first orientation.

Example 2

The shaft guide of Example 1, wherein the second passage proximalopening is horizontally aligned with the first passage proximal opening,and wherein the second passage distal opening is vertically aligned withthe first passage distal opening.

Example 3

The shaft guide of Examples 1 or 2, wherein a first proximal center ofthe first passage proximal opening and a second proximal center of thesecond passage proximal opening lie on a first reference plane. A firstdistal center of the first passage distal opening and a second distalcenter of the second passage distal opening lie on a second referenceplane that is transverse to the first reference plane.

Example 4

The shaft guide of Examples 1 or 3, wherein the second passage proximalopening is vertically aligned with the first passage proximal openingand the second passage distal opening is horizontally aligned with thefirst passage distal opening.

Example 5

The shaft guide of Examples 1 or 2, wherein the first passage proximalopening is located on a first side of a first reference plane and thefirst passage distal opening is located on a first side of a secondreference plane that is transverse to the first reference plane. Thesecond passage proximal opening is located on a second side of the firstreference plane and the second passage distal opening is located on asecond side of the second reference plane.

Example 6

The shaft guide of Examples 3, 4 or 5, wherein a first central portionof said first passage passes through at least one of the first referenceplane and the second reference plane and wherein a second centralportion of said second passage passes through at least one of the firstreference plane and the second reference plane.

Example 7

The shaft guide of Examples 1, 2, 3, 4, 5 or 6, wherein the shaft guideis fabricated from a ductile material that is configured to facilitatetwisting flexure of the shaft guide when the surgical end effector isarticulated about at least one of the first articulation axis and thesecond articulation axis.

Example 8

The shaft guide of Examples 1, 2, 3, 4, 5, 6 or 7, wherein the shaftguide proximal end comprises a proximal oval shape and the shaft guidedistal end comprises a distal oval shape.

Example 9

The shaft guide of Examples 1, 2, 3, 4, 5, 6, 7 or 8, wherein the shaftguide body comprises a central body portion extending between the shaftguide proximal end and the shaft guide distal end and comprises acentrally disposed bulbous segment.

Example 10

The shaft guide of Example 9, wherein the central body portion furthercomprises a proximal body portion located between the centrally disposedbulbous segment and the shaft guide proximal end. The proximal bodyportion comprises a proximal diameter that is less than a diameter ofthe centrally disposed bulbous segment and corresponds to the firstarticulation axis. The central body portion further comprises a distalbody portion located between the centrally disposed bulbous segment andthe shaft guide distal end. The distal body portion comprises a distaldiameter that is less than the diameter of the centrally disposedbulbous segment and corresponds to the second articulation axis.

Example 11

The shaft guide of Example 10, wherein the proximal body portion furthercomprises a first pair of opposed proximal scalloped areas that areproximal to the centrally disposed bulbous segment and a second pair ofopposed distal scalloped areas that are distal to the centrally disposedbulbous segment.

Example 12

A shaft guide for a surgical instrument that includes a shaft assemblythat defines a shaft axis and a surgical end effector that is operablycoupled to the shaft assembly by an articulation joint that facilitatesarticulation of the surgical end effector through a plurality ofarticulation planes relative to the shaft axis. The shaft guidecomprises a shaft guide body that is sized to span across thearticulation joint and comprises a shaft guide proximal end and a shaftguide distal end. The shaft guide further comprises a first passage thatextends through the shaft guide body from the shaft guide proximal endto the shaft guide distal end and is configured to operably support aportion of a first drive shaft therethrough. The first passage opensthrough the shaft guide proximal end on a first side of a referenceplane that extends through the shaft axis and opens through the shaftguide distal end on the first side of the reference plane. A firstcentral portion of the first passage passes through the reference planeat at least two locations. The shaft guide further comprises a secondpassage that extends through the shaft guide body from the shaft guideproximal end to the shaft guide distal end and is configured to operablysupport a portion of a second drive shaft therethrough. The secondpassage opens through the shaft guide proximal end on a second side ofthe reference plane and opens through the shaft guide distal end on thesecond side of the reference plane. A second central portion of thesecond passage passes through the reference plane at at least two otherlocations.

Example 13

The shaft guide of Example 12, wherein the shaft guide is fabricatedfrom a ductile material configured to facilitate twisting flexure of theshaft guide when the surgical end effector is articulated relative tothe shaft assembly.

Example 14

The shaft guide of Examples 12 or 13, wherein the shaft guide proximalend is coupled to the shaft assembly and is configured to rotaterelative thereto, and wherein the shaft guide distal end is coupled tothe surgical end effector and is configured to rotate relative thereto.

Example 15

A surgical instrument comprising a shaft assembly that defines a shaftaxis. A surgical end effector is operably coupled to the shaft assemblyby an articulation joint that defines a first articulation axis aboutwhich the surgical end effector is articulatable relative to the shaftassembly. The first articulation axis is transverse to the shaft axis.The articulation joint further defines a second articulation axis aboutwhich the surgical end effector is articulatable relative to the shaftassembly. The second articulation axis is transverse to the shaft axisand the first articulation axis. The articulation joint comprises ashaft guide that comprises a shaft guide proximal end that is adjacentto the shaft assembly and a shaft guide distal end that is adjacent tothe surgical end effector. The shaft guide further comprises a shaftguide body that spans the articulation joint and the first articulationaxis and the second articulation axis. The shaft guide body defines ashaft guide axis and comprises a first passage that extends through theshaft guide body from the shaft guide proximal end to the shaft guidedistal end and is configured to operably support a portion of a firstdrive shaft. The first passage opens through the shaft guide proximalend on a first side of a first reference plane that extends through theshaft guide axis and opens through the shaft guide distal end on a firstside of a second reference plane that extends through the shaft guideaxis and is transverse to the first reference plane. A first centralportion of the first passage passes through at least one of the firstreference plane and the second reference plane. The shaft guide bodyfurther comprises a second passage that extends through the shaft guidebody from the shaft guide proximal end to the shaft guide distal end andis configured to operably support a portion of a second drive shafttherethrough. The second passage opens through the shaft guide proximalend on a second side of the first reference plane and opens through theshaft guide distal end on a second side of the second reference plane. Asecond central portion of the second passage passes through at least oneof the first reference plane and the second reference plane.

Example 16

The surgical instrument of Example 15, wherein the shaft guide isfabricated from a ductile material configured to facilitate flexure ofthe shaft guide when the surgical end effector is articulated about atleast one of the first articulation axis and the second articulationaxis.

Example 17

The surgical instrument of Examples 15 or 16, wherein the first passagecomprises a first passage proximal end that opens through the shaftguide proximal end and a first passage distal end that opens through theshaft guide distal end. The second passage comprises a second passageproximal end that opens through the shaft guide proximal end and asecond passage distal end that opens through the shaft guide distal end.The first passage proximal end is bisected by the second reference planeand the first passage distal end is bisected by the first referenceplane. The second passage proximal end is bisected by the secondreference plane and the second passage distal end is bisected by thefirst reference plane.

Example 18

The surgical instrument of Examples 15, 16 or 17, wherein the shaftguide proximal end comprises a proximal oval shape and wherein the shaftguide distal end comprises a distal oval shape.

Example 19

The surgical instrument of Example 18, wherein the proximal oval shapecomprises a proximal long axis that is aligned on the first referenceplane, and wherein the distal oval shape comprises a distal long axisthat is aligned on the second reference plane.

Example 20

The surgical instrument of Example 19, wherein the first passagecomprises a first passage proximal end that opens through the shaftguide proximal end and a first passage distal end that opens through theshaft guide distal end. The second passage comprises a second passageproximal end that opens through the shaft guide proximal end and asecond passage distal end that opens through the shaft guide distal end.The first passage proximal end and the second passage proximal end arelaterally spaced from each other on the proximal long axis. The firstpassage distal end and the second passage distal end are verticallyspaced from each other on the distal long axis.

EXAMPLES—SET NO. 3 Example 1

A surgical instrument comprising a shaft assembly that defines a shaftaxis. The surgical instrument further comprises a surgical end effectorand an articulation joint. The articulation joint comprises a proximalmounting member that is attached to the shaft assembly and a distalmounting member that is attached to the surgical end effector. Thearticulation joint further comprises a linkage assembly that comprises afirst link member that comprises a first link proximal end, a first linkdistal end, and a first link body that extends between the first linkproximal end and the first link distal end. The first link proximal endis coupled to the proximal mounting member to enable the first linkproximal end to pivot relative thereto and the first link body to rotateabout the shaft axis during articulation of the surgical end effector.The first link distal end is coupled to the distal mounting member toenable the first link distal end to pivot relative thereto and the firstlink body to rotate about the shaft axis. The linkage assembly furthercomprises a second link member that comprises a second link proximalend, a second link distal end, and a second link body that extendsbetween the second link proximal end and the second link distal end. Thesecond link proximal end is coupled to the proximal mounting member toenable the second link proximal end to pivot relative thereto and thesecond link body to rotate about the shaft axis. The second link distalend is coupled to the distal mounting member to enable the second linkdistal end to pivot relative thereto and the second link body to rotateabout the shaft axis.

Example 2

The surgical instrument of Example 1, wherein the linkage assemblyfurther comprises a third link member that comprises a third linkproximal end, a third link distal end, and a third link body. The thirdlink proximal end is coupled to the proximal mounting member to enablethe third link proximal end to pivot relative thereto and the third linkbody to rotate about the shaft axis. The third link distal end iscoupled to the distal mounting member to enable the third link distalend to pivot relative thereto and the third link body to rotate aboutthe shaft axis.

Example 3

The surgical instrument of Examples 1 or 2, further comprising aflexible shaft guide that spans between the proximal mounting member andthe distal mounting member to operably support at least a portion of atleast one drive shaft therethrough.

Example 4

The surgical instrument of Examples 1, 2 or 3, wherein the linkageassembly is configured to maintain an axial distance between theproximal mounting member and the distal mounting member duringarticulation of the surgical end effector relative to the shaftassembly.

Example 5

The surgical instrument of Examples 1, 2, 3 or 4, wherein the first linkproximal end is attached to the proximal mounting member at a firstproximal attachment location by a first proximal joint assembly that isconfigured to facilitate pivotal travel of the first link proximal endrelative to the proximal mounting member about a two first proximaljoint axes that are transverse to each other. The first link distal endis attached to the distal mounting member at a first distal attachmentlocation on the distal mounting member by a first distal joint assemblythat is configured to facilitate pivotal travel of the first link distalend relative to the distal mounting member about two first distal jointaxes that are transverse to each other. The second link proximal end isattached to the proximal mounting member at a second proximal attachmentlocation by a second proximal joint assembly that is configured tofacilitate pivotal travel of the second link proximal end relative tothe proximal mounting member about two second proximal joint axes thatare transverse to each other. The second link distal end is attached tothe distal mounting member at a second distal attachment location on thedistal mounting member by a second distal joint assembly that isconfigured to facilitate pivotal travel of the second link distal endrelative to the distal mounting member about two second distal jointaxes that are transverse to each other.

Example 6

The surgical instrument of Examples 2, 3 or 5, wherein the third linkproximal end is attached to the proximal mounting member at a thirdproximal attachment location by a third proximal joint assembly that isconfigured to facilitate pivotal travel of the third link proximal endrelative to the proximal mounting member about two third proximal jointaxes that are transverse to each other. The third link distal end isattached to the distal mounting member at a third distal attachmentlocation on the distal mounting member by a third distal joint assemblythat is configured to facilitate pivotal travel of the third link distalend relative to the distal mounting member about two third distal jointaxes that are transverse to each other.

Example 7

The surgical instrument of Examples 6, wherein first link proximal endis attached to the proximal mounting member at a first proximalattachment location by a first proximal joint assembly that isconfigured to facilitate pivotal travel of the first link proximal endrelative to the proximal mounting member about a two first proximaljoint axes that are transverse to each other. The first link distal endis attached to the distal mounting member at a first distal attachmentlocation on the distal mounting member by a first distal joint assemblythat is configured to facilitate pivotal travel of the first link distalend relative to the distal mounting member about two first distal jointaxes that are transverse to each other. The second link proximal end isattached to the proximal mounting member at a second proximal attachmentlocation by a second proximal joint assembly that is configured tofacilitate pivotal travel of the second link proximal end relative tothe proximal mounting member about two second proximal joint axes thatare transverse to each other. The second link distal end is attached tothe distal mounting member at a second distal attachment location on thedistal mounting member by a second distal joint assembly that isconfigured to facilitate pivotal travel of the second link distal endrelative to the distal mounting member about two second distal jointaxes that are transverse to each other.

Example 8

The surgical instrument of Examples 2, 3, 6 or 7, wherein when thedistal mounting member is axially aligned with the proximal mountingmember on the shaft axis, the first distal attachment location on thedistal mounting member is diametrically opposite to the first proximalattachment location on the proximal mounting member, the second distalattachment location on the distal mounting member is diametricallyopposite to the second proximal attachment location on the proximalmounting member, and the third distal attachment location on the distalmounting member is diametrically opposite to the third proximalattachment location on the proximal mounting member.

Example 9

The surgical instrument of Example 3, wherein the first link bodycomprises at least one first link curved surface that is configured toaccommodate passage of the flexible shaft guide between the proximalmounting member and the distal mounting member. The second link bodycomprises at least one second link curved surface that is configured toaccommodate passage of the flexible shaft guide between the proximalmounting member and the distal mounting member. The third link bodycomprises at least one third link curved surface that is configured toaccommodate passage of the flexible shaft guide between the proximalmounting member and the distal mounting member.

Example 10

The surgical instrument of Examples 3 or 9, wherein the flexible shaftguide is rotatably movable relative to at least one of the proximalmounting member and the distal mounting member.

Example 11

The surgical instrument of Examples 3, 9 or 10, wherein the flexibleshaft guide comprises a shaft guide body that is sized to extend betweenthe proximal mounting member and the distal mounting member. The shaftguide body comprises a shaft guide proximal end portion that isconfigured to be retained in a proximal shaft hole in the proximalmounting member and rotate therein. The shaft guide body furthercomprises a proximal flexible ribbed segment located adjacent to theshaft guide proximal end portion. The shaft guide body additionallycomprises a shaft guide distal end portion that is configured to beretained in a distal shaft hole in the distal mounting member and rotatetherein. A distal flexible ribbed segment is located adjacent to theshaft guide distal end portion.

Example 12

The surgical instrument of Example 11, wherein the flexible shaft guidefurther comprises a first passage that extends through the shaft guidebody from the shaft guide proximal end to the shaft guide distal end andis configured to operably support a portion of a first drive shafttherethrough. The first passage opens through the shaft guide proximalend on a first side of a reference plane that extends through the shaftaxis. The first passage opens through the shaft guide distal end on thefirst side of the reference plane and a first central portion of thefirst passage passes through the reference plane at at least two firstlocations. The flexible shaft guide further comprises a second passagethat extends through the shaft guide body from the shaft guide proximalend to the shaft guide distal end and is configured to operably supporta portion of a second drive shaft therethrough. The second passage opensthrough the shaft guide proximal end on a second side of the referenceplane. The second passage opens through the shaft guide distal end onthe second side of the reference plane and a second central portion ofthe second passage passes through the reference plane at at least twosecond locations.

Example 13

The surgical instrument of Example 7, wherein the first proximal jointassembly comprises a first proximal attachment link that is pivotallycoupled to the first link proximal end to facilitate pivotal travel ofthe first link proximal end relative to the first proximal attachmentlink about one of the first proximal joint axes. The first proximalattachment link is pivotally coupled to the proximal mounting member forpivotal travel relative thereto about the other one of the firstproximal joint axes. The second proximal joint assembly comprises asecond proximal attachment link that is pivotally coupled to the secondlink proximal end to facilitate pivotal travel of the second linkproximal end relative to the second proximal attachment link about oneof the second proximal joint axes. The second proximal attachment linkis pivotally coupled to the proximal mounting member for pivotal travelrelative thereto about the other one of the second proximal joint axes.The third proximal joint assembly comprises a third proximal attachmentlink that is pivotally coupled to the third link proximal end tofacilitate pivotal travel of the third link proximal end relative to thethird proximal attachment link about one of the third proximal jointaxis. The third proximal attachment link is pivotally coupled to theproximal mounting member for pivotal travel relative thereto about theother one of the third proximal joint axes.

Example 14

The surgical instrument of Examples 7 or 13, wherein the first distaljoint assembly comprises a first distal attachment link pivotally thatis coupled to the first link distal end to facilitate pivotal travel ofthe first link distal end relative to the first distal attachment linkabout one of the first distal joint axes. The first distal attachmentlink is pivotally coupled to the distal mounting member for pivotaltravel relative thereto about the other one of the first distal jointaxes. The second distal joint assembly comprises a second distalattachment link that is pivotally coupled to the second link distal endto facilitate pivotal travel of the second link distal end relative tothe second distal attachment link about one of the second distal jointaxes. The second distal attachment link is pivotally coupled to thedistal mounting member for pivotal travel relative thereto about theother one of the second distal joint axes. The third distal jointassembly comprises a third distal attachment link that is pivotallycoupled to the third link distal end to facilitate pivotal travel of thethird link distal end relative to the third distal attachment link aboutone of the third distal joint axis. The third distal attachment link ispivotally coupled to the distal mounting member for pivotal travelrelative thereto about the other one of the third distal joint axes.

Example 15

The surgical instrument of Examples 7, 13 or 14, wherein the first linkmember, the first proximal joint assembly, and the first distal jointassembly are formed as a single first link assembly by a threedimensional printing process. The second link member, the secondproximal joint assembly, and the second distal joint assembly are formedas a single second link assembly by the three dimensional printingprocess. The third link member, the third proximal joint assembly, andthe third distal joint assembly are formed as a single third linkassembly by the three dimensional printing process.

Example 16

The surgical instrument of Examples 7, 13, 14 or 15, wherein the firstproximal joint assembly interfaces with the proximal mounting member tofacilitate axial movement of the first proximal joint assembly relativeto the proximal mounting member. The second proximal joint assemblyinterfaces with the proximal mounting member to facilitate axialmovement of the second proximal joint assembly relative to the proximalmounting member. The third proximal joint assembly interfaces with theproximal mounting member to facilitate axial movement of the thirdproximal joint assembly relative to the proximal mounting member.

Example 17

The surgical instrument of Examples 7, 13, 14, 15 or 16 wherein thefirst distal joint assembly interfaces with the distal mounting memberto facilitate axial movement of the first distal joint assembly relativeto the distal mounting member. The second distal joint assemblyinterfaces with the distal mounting member to facilitate axial movementof the second distal joint assembly relative to the distal mountingmember. The third distal joint assembly interfaces with the distalmounting member to facilitate axial movement of the third distal jointassembly relative to the distal mounting member.

Example 18

The surgical instrument of Examples 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12,13, 14, 15, 16 or 17, wherein the first link member comprises a firstcircular cross-sectional shape. The second link member comprises asecond circular cross-sectional shape. The third link member comprises athird circular cross-sectional shape.

Example 19

The surgical instrument of Examples 2, 3, 4, 5, 6, 7,8, 9, 10, 11, 12,13, 14 15, 16, 17 or 18, wherein the first link body is partiallytwisted about the shaft axis. The second link body is partially twistedabout the shaft axis. The third link body is partially twisted about theshaft axis.

Example 20

An articulation joint assembly for facilitating multi-axis articulationof a surgical end effector relative to a shaft assembly of a surgicalinstrument. The articulation joint assembly comprises a proximalmounting member that is configured to interface with the shaft assemblyand a distal mounting member that is configured to interface with thesurgical end effector. The articulation joint assembly further comprisesa linkage assembly that comprises a first link member that comprise afirst link proximal end that operably interfaces with the proximalmounting member such that the first link proximal end is axially movablerelative to the proximal mounting member and is pivotable about twofirst proximal joint axes that are transverse to each other. The firstlink member further comprises a first link distal end that operablyinterfaces with the distal mounting member such that the first linkdistal end is axially movable relative to the distal mounting member andis pivotable about two first distal joint axes that are transverse toeach other. The linkage assembly further comprises a second link memberthat comprises a second link proximal end that operably interfaces withthe proximal mounting member such that the second link proximal end isaxially movable relative to the proximal mounting member and ispivotable about two second proximal joint axes that are transverse toeach other. The second link member further comprises a second linkdistal end that operably interfaces with the distal mounting member suchthat the second link distal end is axially movable relative to thedistal mounting member and is pivotable about two second distal jointaxes that are transverse to each other. The linkage assembly alsocomprises a third link member that comprises a third link proximal endthat operably interfaces with the proximal mounting member such that thethird link proximal end is axially movable relative to the proximalmounting member and is pivotable about two third proximal joint axesthat are transverse to each other. The third link member furthercomprises a third link distal end that operably interfaces with thedistal mounting member such that the third link distal end is axiallymovable relative to the distal mounting member and is pivotable abouttwo third distal joint axes that are transverse to each other.

Example 21

The articulation joint assembly of Example 20, further comprising aflexible shaft guide that spans between the proximal mounting member andthe distal mounting member to flexibly support two drive shaftsextending therebetween.

Many of the surgical instrument systems described herein are motivatedby an electric motor; however, the surgical instrument systems describedherein can be motivated in any suitable manner. In various instances,the surgical instrument systems described herein can be motivated by amanually-operated trigger, for example. In certain instances, the motorsdisclosed herein may comprise a portion or portions of a roboticallycontrolled system. Moreover, any of the end effectors and/or toolassemblies disclosed herein can be utilized with a robotic surgicalinstrument system. U.S. patent application Ser. No. 13/118,241, entitledSURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS, now U.S. Pat. No. 9,072,535, for example, disclosesseveral examples of a robotic surgical instrument system in greaterdetail.

The surgical instrument systems described herein have been described inconnection with the deployment and deformation of staples; however, theembodiments described herein are not so limited. Various embodiments areenvisioned which deploy fasteners other than staples, such as clamps ortacks, for example. Moreover, various embodiments are envisioned whichutilize any suitable means for sealing tissue. For instance, an endeffector in accordance with various embodiments can comprise electrodesconfigured to heat and seal the tissue. Also, for instance, an endeffector in accordance with certain embodiments can apply vibrationalenergy to seal the tissue.

The entire disclosures of:

-   -   U.S. Pat. No. 5,403,312, entitled ELECTROSURGICAL HEMOSTATIC        DEVICE, which issued on Apr. 4, 1995;    -   U.S. Pat. No. 7,000,818, entitled SURGICAL STAPLING INSTRUMENT        HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS, which        issued on Feb. 21, 2006;    -   U.S. Pat. No. 7,422,139, entitled MOTOR-DRIVEN SURGICAL CUTTING        AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK, which        issued on Sep. 9, 2008;    -   U.S. Pat. No. 7,464,849, entitled ELECTRO-MECHANICAL SURGICAL        INSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS,        which issued on Dec. 16, 2008;    -   U.S. Pat. No. 7,670,334, entitled SURGICAL INSTRUMENT HAVING AN        ARTICULATING END EFFECTOR, which issued on Mar. 2, 2010;    -   U.S. Pat. No. 7,753,245, entitled SURGICAL STAPLING INSTRUMENTS,        which issued on Jul. 13, 2010;    -   U.S. Pat. No. 8,393,514, entitled SELECTIVELY ORIENTABLE        IMPLANTABLE FASTENER CARTRIDGE, which issued on Mar. 12, 2013;    -   U.S. patent application Ser. No. 11/343,803, entitled SURGICAL        INSTRUMENT HAVING RECORDING CAPABILITIES, now U.S. Pat. No.        7,845,537;    -   U.S. patent application Ser. No. 12/031,573, entitled SURGICAL        CUTTING AND FASTENING INSTRUMENT HAVING RF ELECTRODES, filed        Feb. 14, 2008;    -   U.S. patent application Ser. No. 12/031,873, entitled END        EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT, filed        Feb. 15, 2008, now U.S. Pat. No. 7,980,443;    -   U.S. patent application Ser. No. 12/235,782, entitled        MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT, now U.S. Pat. No.        8,210,411;    -   U.S. patent application Ser. No. 12/249,117, entitled POWERED        SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY        RETRACTABLE FIRING SYSTEM, now U.S. Pat. No. 8,608,045;    -   U.S. patent application Ser. No. 12/647,100, entitled        MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT WITH ELECTRIC ACTUATOR        DIRECTIONAL CONTROL ASSEMBLY, filed Dec. 24, 2009, now U.S. Pat.        No. 8,220,688;    -   U.S. patent application Ser. No. 12/893,461, entitled STAPLE        CARTRIDGE, filed Sep. 29, 2012, now U.S. Pat. No. 8,733,613;    -   U.S. patent application Ser. No. 13/036,647, entitled SURGICAL        STAPLING INSTRUMENT, filed Feb. 28, 2011, now U.S. Pat. No.        8,561,870;    -   U.S. patent application Ser. No. 13/118,241, entitled SURGICAL        STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT        ARRANGEMENTS, now U.S. Pat. No. 9,072,535;    -   U.S. patent application Ser. No. 13/524,049, entitled        ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE,        filed on Jun. 15, 2012, now U.S. Pat. No. 9,101,358;    -   U.S. patent application Ser. No. 13/800,025, entitled STAPLE        CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed on Mar. 13,        2013, now U.S. Pat. No. 9,345,481;    -   U.S. patent application Ser. No. 13/800,067, entitled STAPLE        CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed on Mar. 13,        2013, now U.S. Patent Application Publication No. 2014/0263552;    -   U.S. Patent Application Publication No. 2007/0175955, entitled        SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER        LOCKING MECHANISM, filed Jan. 31, 2006; and    -   U.S. Patent Application Publication No. 2010/0264194, entitled        SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATABLE END EFFECTOR,        filed Apr. 12, 2010, now U.S. Pat. No. 8,308,040, are hereby        incorporated by reference herein.

Although various devices have been described herein in connection withcertain embodiments, modifications and variations to those embodimentsmay be implemented. Particular features, structures, or characteristicsmay be combined in any suitable manner in one or more embodiments. Thus,the particular features, structures, or characteristics illustrated ordescribed in connection with one embodiment may be combined in whole orin part, with the features, structures or characteristics of one or moreother embodiments without limitation. Also, where materials aredisclosed for certain components, other materials may be used.Furthermore, according to various embodiments, a single component may bereplaced by multiple components, and multiple components may be replacedby a single component, to perform a given function or functions. Theforegoing description and following claims are intended to cover allsuch modification and variations.

The devices disclosed herein can be designed to be disposed of after asingle use, or they can be designed to be used multiple times. In eithercase, however, a device can be reconditioned for reuse after at leastone use. Reconditioning can include any combination of the stepsincluding, but not limited to, the disassembly of the device, followedby cleaning or replacement of particular pieces of the device, andsubsequent reassembly of the device. In particular, a reconditioningfacility and/or surgical team can disassemble a device and, aftercleaning and/or replacing particular parts of the device, the device canbe reassembled for subsequent use. Those skilled in the art willappreciate that reconditioning of a device can utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

The devices disclosed herein may be processed before surgery. First, anew or used instrument may be obtained and, when necessary, cleaned. Theinstrument may then be sterilized. In one sterilization technique, theinstrument is placed in a closed and sealed container, such as a plasticor TYVEK bag. The container and instrument may then be placed in a fieldof radiation that can penetrate the container, such as gamma radiation,x-rays, and/or high-energy electrons. The radiation may kill bacteria onthe instrument and in the container. The sterilized instrument may thenbe stored in the sterile container. The sealed container may keep theinstrument sterile until it is opened in a medical facility. A devicemay also be sterilized using any other technique known in the art,including but not limited to beta radiation, gamma radiation, ethyleneoxide, plasma peroxide, and/or steam.

While this invention has been described as having exemplary designs, thepresent invention may be further modified within the spirit and scope ofthe disclosure. This application is therefore intended to cover anyvariations, uses, or adaptations of the invention using its generalprinciples.

Any patent, publication, or other disclosure material, in whole or inpart, that is said to be incorporated by reference herein isincorporated herein only to the extent that the incorporated materialsdo not conflict with existing definitions, statements, or otherdisclosure material set forth in this disclosure. As such, and to theextent necessary, the disclosure as explicitly set forth hereinsupersedes any conflicting material incorporated herein by reference.Any material, or portion thereof, that is said to be incorporated byreference herein, but which conflicts with existing definitions,statements, or other disclosure material set forth herein will only beincorporated to the extent that no conflict arises between thatincorporated material and the existing disclosure material.

What is claimed is:
 1. A surgical instrument, comprising: a shaftassembly, wherein said shaft assembly defines a shaft axis; a surgicalend effector; an articulation joint comprising: a proximal mountingmember operably interfacing with said shaft assembly; a distal mountingmember operably interfacing with said surgical end effector; and alinkage assembly comprising: a first link member comprising a first linkproximal end, a first link distal end, and a first link body extendingtherebetween, wherein said first link proximal end is coupled to saidproximal mounting member to enable said first link proximal end to pivotrelative thereto and said first link body to rotate about the shaft axisduring articulation of said surgical end effector, and wherein saidfirst link distal end is coupled to said distal mounting member toenable said first link distal end to pivot relative thereto and saidfirst link body to rotate about the shaft axis; and a second link membercomprising a second link proximal end, a second link distal end, and asecond link body extending therebetween, wherein said second linkproximal end is coupled to said proximal mounting member to enable saidsecond link proximal end to pivot relative thereto and said second linkbody to rotate about the shaft axis, and wherein said second link distalend is coupled to said distal mounting member to enable said second linkdistal end to pivot relative thereto and said second link body to rotateabout the shaft axis.
 2. The surgical instrument of claim 1, whereinsaid linkage assembly further comprises a third link member comprising athird link proximal end, a third link distal end, and a third link body,wherein said third link proximal end is coupled to said proximalmounting member to enable said third link proximal end to pivot relativethereto and said third link body to rotate about the shaft axis, andwherein said third link distal end is coupled to said distal mountingmember to enable said third link distal end to pivot relative theretoand said third link body to rotate about the shaft axis.
 3. The surgicalinstrument of claim 2, further comprising a flexible shaft guidespanning between said proximal mounting member and said distal mountingmember to operably support at least a portion of at least one driveshaft therethrough.
 4. The surgical instrument of claim 1, wherein saidlinkage assembly is configured to maintain an axial distance betweensaid proximal mounting member and said distal mounting member duringarticulation of said surgical end effector relative to said shaftassembly.
 5. The surgical instrument of claim 1, wherein said first linkproximal end is attached to said proximal mounting member at a firstproximal attachment location by a first proximal joint assemblyconfigured to facilitate pivotal travel of said first link proximal endrelative to said proximal mounting member about two first proximal jointaxes that are transverse to each other, wherein said first link distalend is attached to said distal mounting member at a first distalattachment location on said distal mounting member by a first distaljoint assembly configured to facilitate pivotal travel of said firstlink distal end relative to said distal mounting member about two firstdistal joint axes that are transverse to each other, wherein said secondlink proximal end is attached to said proximal mounting member at asecond proximal attachment location by a second proximal joint assemblyconfigured to facilitate pivotal travel of said second link proximal endrelative to said proximal mounting member about two second proximaljoint axes that are transverse to each other, and wherein said secondlink distal end is attached to said distal mounting member at a seconddistal attachment location on said distal mounting member by a seconddistal joint assembly configured to facilitate pivotal travel of saidsecond link distal end relative to said distal mounting member about twosecond distal joint axes that are transverse to each other.
 6. Thesurgical instrument of claim 2, wherein said third link proximal end isattached to said proximal mounting member at a third proximal attachmentlocation by a third proximal joint assembly configured to facilitatepivotal travel of said third link proximal end relative to said proximalmounting member about two third proximal joint axes that are transverseto each other, and wherein said third link distal end is attached tosaid distal mounting member at a third distal attachment location onsaid distal mounting member by a third distal joint assembly configuredto facilitate pivotal travel of said third link distal end relative tosaid distal mounting member about two third distal joint axes that aretransverse to each other.
 7. The surgical instrument of claim 6, whereinsaid first link proximal end is attached to said proximal mountingmember at a first proximal attachment location by a first proximal jointassembly configured to facilitate pivotal travel of said first linkproximal end relative to said proximal mounting member about two firstproximal joint axes that are transverse to each other, wherein saidfirst link distal end is attached to said distal mounting member at afirst distal attachment location on said distal mounting member by afirst distal joint assembly configured to facilitate pivotal travel ofsaid first link distal end relative to said distal mounting member abouttwo first distal joint axes that are transverse to each other, whereinsaid second link proximal end is attached to said proximal mountingmember at a second proximal attachment location by a second proximaljoint assembly configured to facilitate pivotal travel of said secondlink proximal end relative to said proximal mounting member about twosecond proximal joint axes that are transverse to each other, andwherein said second link distal end is attached to said distal mountingmember at a second distal attachment location on said distal mountingmember by a second distal joint assembly configured to facilitatepivotal travel of said second link distal end relative to said distalmounting member about two second distal joint axes that are transverseto each other.
 8. The surgical instrument of claim 2, wherein when saiddistal mounting member is axially aligned with said proximal mountingmember on the shaft axis, the first distal attachment location on saiddistal mounting member is diametrically opposite to the first proximalattachment location on said proximal mounting member, the second distalattachment location on said distal mounting member is diametricallyopposite to the second proximal attachment location on said proximalmounting member, and the third distal attachment location on said distalmounting member is diametrically opposite to the third proximalattachment location on said proximal mounting member.
 9. The surgicalinstrument of claim 2, wherein said first link body comprises at leastone first link curved surface configured to accommodate passage of saidflexible shaft guide between said proximal mounting member and saiddistal mounting member, wherein said second link body comprises at leastone second link curved surface configured to accommodate passage of saidflexible shaft guide between said proximal mounting member and saiddistal mounting member, and wherein said third link body comprises atleast one third link curved surface configured to accommodate passage ofsaid flexible shaft guide between said proximal mounting member and saiddistal mounting member.
 10. The surgical instrument of claim 3, whereinsaid flexible shaft guide is rotatably movable relative to at least oneof said proximal mounting member and said distal mounting member. 11.The surgical instrument of claim 10, wherein said flexible shaft guidecomprises: a shaft guide body sized to extend between said proximalmounting member and said distal mounting member, wherein said shaftguide body comprises: a shaft guide proximal end portion configured tobe retained in said proximal shaft hole in said proximal mounting memberand rotate therein; a proximal flexible ribbed segment adjacent saidshaft guide proximal end portion; a shaft guide distal end portionconfigured to be retained in a distal shaft hole in said distal mountingmember and rotate therein; and a distal flexible ribbed segment adjacentsaid shaft guide distal end portion.
 12. The surgical instrument ofclaim 3, wherein said flexible shaft guide further comprises: a firstpassage extending through said shaft guide body from said shaft guideproximal end to said shaft guide distal end and configured to operablysupport a portion of a first drive shaft therethrough, wherein saidfirst passage opens through said shaft guide proximal end on a firstside of a reference plane extending through the shaft axis, wherein saidfirst passage opens through said shaft guide distal end on the firstside of the reference plane, and wherein a first central portion of saidfirst passage passes through the reference plane at at least two firstlocations; and a second passage extending through said shaft guide bodyfrom said shaft guide proximal end to said shaft guide distal end andconfigured to operably support a portion of a second drive shafttherethrough, wherein said second passage opens through said shaft guideproximal end on a second side of the reference plane, wherein saidsecond passage opens through said shaft guide distal end on the secondside of the reference plane, and wherein a second central portion ofsaid second passage passes through the reference plane at at least twosecond locations.
 13. The surgical instrument of claim 7, wherein saidfirst proximal joint assembly comprises a first proximal attachment linkpivotally coupled to said first link proximal end to facilitate pivotaltravel of said first link proximal end relative to said first proximalattachment link about one of the first proximal joint axes, wherein saidfirst proximal attachment link is pivotally coupled to said proximalmounting member for pivotal travel relative thereto about the other oneof the first proximal joint axes, and wherein said second proximal jointassembly comprises a second proximal attachment link pivotally coupledto said second link proximal end to facilitate pivotal travel of saidsecond link proximal end relative to said second proximal attachmentlink about one of the second proximal joint axes, wherein said secondproximal attachment link is pivotally coupled to said proximal mountingmember for pivotal travel relative thereto about the other one of thesecond proximal joint axes, and wherein said third proximal jointassembly comprises a third proximal attachment link pivotally coupled tosaid third link proximal end to facilitate pivotal travel of said thirdlink proximal end relative to said third proximal attachment link aboutone of the third proximal joint axis, wherein said third proximalattachment link is pivotally coupled to said proximal mounting memberfor pivotal travel relative thereto about the other one of the thirdproximal joint axes.
 14. The surgical instrument of claim 7, whereinsaid first distal joint assembly comprises a first distal attachmentlink pivotally coupled to said first link distal end to facilitatepivotal travel of said first link distal end relative to said firstdistal attachment link about one of the first distal joint axes, whereinsaid first distal attachment link is pivotally coupled to said distalmounting member for pivotal travel relative thereto about the other oneof the first distal joint axes, and wherein said second distal jointassembly comprises a second distal attachment link pivotally coupled tosaid second link distal end to facilitate pivotal travel of said secondlink distal end relative to said second distal attachment link about oneof the second distal joint axes, wherein said second distal attachmentlink is pivotally coupled to said distal mounting member for pivotaltravel relative thereto about the other one of the second distal jointaxes, and wherein said third distal joint assembly comprises a thirddistal attachment link pivotally coupled to said third link distal endto facilitate pivotal travel of said third link distal end relative tosaid third distal attachment link about one of the third distal jointaxis, wherein said third distal attachment link is pivotally coupled tosaid distal mounting member for pivotal travel relative thereto aboutthe other one of the third distal joint axes.
 15. The surgicalinstrument of claim 7, wherein said first link member, said firstproximal joint assembly, and said first distal joint assembly are formedas a single first link assembly by a three dimensional printing process,wherein said second link member, said second proximal joint assembly,and said second distal joint assembly are formed as a single second linkassembly by said three dimensional printing process, and wherein saidthird link member, said third proximal joint assembly, and said thirddistal joint assembly are formed as a single third link assembly by saidthree dimensional printing process.
 16. The surgical instrument of claim7, wherein said first proximal joint assembly interfaces with saidproximal mounting member to facilitate axial movement of said firstproximal joint assembly relative to said proximal mounting member,wherein said second proximal joint assembly interfaces with saidproximal mounting member to facilitate axial movement of said secondproximal joint assembly relative to said proximal mounting member, andwherein said third proximal joint assembly interfaces with said proximalmounting member to facilitate axial movement of said third proximaljoint assembly relative to said proximal mounting member.
 17. Thesurgical instrument of claim 7, wherein said first distal joint assemblyinterfaces with said distal mounting member to facilitate axial movementof said first distal joint assembly relative to said distal mountingmember, wherein said second distal joint assembly interfaces with saiddistal mounting member to facilitate axial movement of said seconddistal joint assembly relative to said distal mounting member, andwherein said third distal joint assembly interfaces with said distalmounting member to facilitate axial movement of said third distal jointassembly relative to said distal mounting member.
 18. The surgicalinstrument of claim 2, wherein said first link member comprises a firstcircular cross-sectional shape, wherein said second link membercomprises a second circular cross-sectional shape, and wherein saidthird link member comprises a third circular cross-sectional shape. 19.The surgical instrument of claim 2, wherein said first link body ispartially twisted about the shaft axis, wherein said second link body ispartially twisted about the shaft axis, and wherein said third link bodyis partially twisted about the shaft axis.
 20. An articulation jointassembly for facilitating multi-axis articulation of a surgical endeffector relative to a shaft assembly of a surgical instrument, whereinsaid articulation joint assembly comprises: a proximal mounting memberconfigured to interface with the shaft assembly; a distal mountingmember configured to interface with the surgical end effector; and alinkage assembly comprising: a first link member comprising a first linkproximal end operably interfacing with said proximal mounting membersuch that said first link proximal end is axially movable relative tosaid proximal mounting member and is pivotable about two first proximaljoint axes that are transverse to each other, wherein said first linkmember further comprises a first link distal end operably interfacingwith said distal mounting member such that said first link distal end isaxially movable relative to said distal mounting member and is pivotableabout two first distal joint axes that are transverse to each other; asecond link member comprising a second link proximal end operablyinterfacing with said proximal mounting member such that said secondlink proximal end is axially movable relative to said proximal mountingmember and is pivotable about two second proximal joint axes that aretransverse to each other, wherein said second link member furthercomprises a second link distal end operably interfacing with said distalmounting member such that said second link distal end is axially movablerelative to said distal mounting member and is pivotable about twosecond distal joint axes that are transverse to each other; and a thirdlink member comprising a third link proximal end operably interfacingwith said proximal mounting member such that said third link proximalend is axially movable relative to said proximal mounting member and ispivotable about two third proximal joint axes that are transverse toeach other, wherein said third link member further comprises a thirdlink distal end operably interfacing with said distal mounting membersuch that said third link distal end is axially movable relative to saiddistal mounting member and is pivotable about two third distal jointaxes that are transverse to each other.
 21. The articulation jointassembly of claim 20, further comprising a flexible shaft guide spanningbetween said proximal mounting member and said distal mounting member toflexibly support two drive shafts spanning therebetween.